HomeMy WebLinkAboutPP PERMIT APPLICATION PAVILIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/11/21 Permit Number:
goo MNRFc F_ 0 t; u o �k - Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial x Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Pavilion
PROPOSED IMPROVEMENT LOCATION:
Address: 5445 Palmetto Avenue, Ft. Pierce, FL 34982
Property Tax ID #: 3403-502-0215-000-7
Site Plan Name: The Petravice Preserve
Project Name: The Petravice Preserve Pavilion
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I
Erect a 24' X 36' pre-engineered, prefabricated pavilion
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
Total Sq. Ft of Construction: 864
Cost of Construction: $ 52,522.30
_ Generator _ Roof
Sq. Ft. of First Floor: 864
3:12 Pitch
Utilities: —Sewer —Septic Building Height: 11'
OWNER/LESSEE:
CONTRACTOR:
NameSt Lucie County Board of County Commissioners
Name: Randy Thomas
Address:2300 Virginia Ave
Company:Aqua Waste Repairs, Inc.
City: Ft. Pierce State: _
Zip Code: 34982 Fax:
Phone No.772-462-2897
Address:3575 Sneed Road
City: Ft. Pierce State: FL
Zip Code: 34945 Fax: 772-461-6668
Phone No772-461-6228
E-Mail:middlebrookm@stlucieco.org
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailawrinc@hotmail.com
State or County License FL CGC 1507436
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: x Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name: North American Specialty Insurance Company
Address:
Address: 1200 Main Street Suite 800
City:
City. Kansas City, MO
Zip: salon Phone:407-786-7770
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.
A.C.Ae�
t5z-0��
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OFSt. Lucie
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 12020 by
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
this 18th day of May 2020 by
Randy Thomas
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Personally Known x OR Produced Identification
Type of Identification
Produced
Produced
ON
(Si ure of Notary Public- S orida) PA G*81
�ar i #
pM 0kc)N
tp� CS. oy obll 9
Commission No. cc910353 `*; o$e'iR� p�btk�
3
2
(Signature of Notary Public- State of Florida)
Commission No. (Seal)
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
Ils