HomeMy WebLinkAbout1 - Building Permit Application Bag HouseAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
ICOUNTY
' R I D ABuilding Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR.
PROPOSED IMPROVEMENT LOCATION.
Address: 9675 Range Line Road, Port St. Lucie, FL 34987
Property Tax ID #: 4201-113-0010-010-6 and 4201-113=0001-020-9 Lot No.
Site Plan Name: Liberty Tire Recycling Block No.
Project Name: Liberty Tire Recycling
DETAILED DESCRIPTION OF WORK.
Installation of bag house.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION.
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: NIA Sq. Ft. of First Floor: N/A
Cost of Construction. $ 187900400 Utilities: _ Sewer _ Septic Building Height: N/A
OWNER/LESSEE:
CONTRACTOR.
Name Liberty Tire Recycling, LLC
Name: Thomas Kimball
Address: 600 River Avenue
Company: High Tech Ductwerks, Inc.
City: Pittsburgh State: FL
Zip Code: 15212 Fax:
Phone No. 772465-0477
Address: 6154 126th Avenue Unit E
City: Largo State: FL
Zip Code: 34773 Fax:
Phone No 772=473=0538
E-Mail: kbloomer@libertytire.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail ductwerks@aol.com
State or County License CSC1110328
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name: Kice Industries Inc.
Name:
Address: 5500 Mill Heiahts Drive
City: Wichita State: KS
Zip: 67219 Phone 316-744-7151
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
Signature of Contractor/License Holder
Signature of Owner Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF L ��
STATE OF FL ID 1
COUNTY OF� JZ \AS
Sworn to (or affirmed) and subscribed before me of
Physical Prce or Online Notarization
ese
this . .`' day of J i 20211 by
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Sworn to (or affirmed) and subscribed before me of
✓Physical Pre ence r Online Notarization
1 y
this day of 11 YO
mdie
Name of person making statement.
Personally Known OR Produced Identification
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produce
Type of Identification
ProducedFL DL ASA2aMS62b
10
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(Signature of Notary Pub ic- State of Florida
NOTARY
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STATE Of
Commission No �� �� (S Comm# G
Expires
FLORIDA m. expires Nov. 14120
Wmission No.
7/2024
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