HomeMy WebLinkAboutBuildingPermitApplication-signed-notorizedDocuSign Envelope ID: El849B62-C133-4A76.97BA-7F5B9DC96442
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
6/4/2021 1 11:49:58 AM CDT
Date: Permit Number:
ccou � ,
h C. L ° L.) (a;- Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial YES Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:AUTOZONE STORES, LLC
PROPOSED IMPROVEMENT LOCATION:
Address: 4892 N KING HWY, FORT PIERCE, FL 34951
Property Tax ID #: 131323200010004
Site Plan Name:
Project Name: AUTOZONE STORE #3607
I DETAILED DESCRIPTION OF WORK:
Remodel existing building to accommodated auto part retail store for AutoZone Srores, LLC
New Electrical Meter NO Second Electrical Meter NO
Lot No.
Block No.
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit— check all that apply:
X Mechanical _ Gas Tank _ Gas Piping _ Shutters X Windows/Doors _ Pond
X Electric X Plumbing XSprinklers
Total Sq. Ft of Construction: 7343
Cost of Construction: $ 392,700
_ Generator _ Roof
Sq. Ft. of First Floor: 7343
Pitch
Utilities: —Sewer — Septic Building Height: 19,
OWNER/LESSEE:
CONTRACTOR:
Name NORTH KINGS HWY,LLC INDRIO CROSSINGS clo COI
f ;I1ANKER
Address:411 N US HWY 1
Company:TBD
City: PIERCE State: FL
Address:
Zip Code: 34951 Fax:
City: State:
Phone No.772-370-1399
Zip Code: Fax:
E-Mail: indrio.crossings.plaza@gmail.com
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail
from the Owner listed above)
State or County License
If value of construction Is Z500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,5W or more, a RECORDED Notice of Commencement is required.
DocuSign Envelope ID: E1849B62-C1334A76-97BA-7F5B9DC96442
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: PHIL PECORD
Name:
Address:123 S FRONT STREET
Address:
City: MEMPHIS State: TN
City: State:
Zip:38018 Phone901-495-8706
Zip: Phone:
FEE SIMPLE TITLEHOLDER: — Not Applicable
BONDING COMPANY: Not Applicable
Name: AUTOZONESTORE.LLC _
Name:
Address: 3�5 FFQNT,STREET
Address:
City: MEMPd(5, IN _ R^^
City:
Zip: Phone:
Zip:38103 Phone:901-495-8706
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 structu res, 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 attornev before commencina work or recordine vour Notice of Commencement.
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ign fur o wiser/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF PWR1TrAI 4JAci �"
STATE OF FLORIDA
COUNTY OF Ac Q64
COUNTY OF_
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this day of �'�•+�_ .202IV, by
this day of . , 2020 by
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Name of person making statement. .�`—''�
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Personally Known OR Produced Identification
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Type of Identification
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Produced
(Signature of Notary Public- State offiarta'a I+iiiiii+►
(Signature of Notary Public- State of Florida }
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Commission No. (Seal)
Commission No. (Seal)
My Commission Expires
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