HomeMy WebLinkAboutCROSSROAD PLAZA-10616All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0610812027
17o LL Li c E E
0
PIcinning and Development Services
Building and COde Regulation Di vision
Permit lumber:
Building Permit Application
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 fax: (772) 462-1575
Commercial X
PERMIT APPLICATION FOR: CROSSROADS CENTER
PROPOSED IMPROVEMENT LOCATION:
Address: 10b16 (J5 HWY 1 PORT SAINT LUClE FLORIDA, 34952
Property Tax ID t
Site Plan Name.- ANDREL)CA INC
Project Narne. CROSSROAD CENTER
FDE TAlLED DESCRIPTION OF WORK;
INSTALS A NEV1f 3 TON 14 SEES 1 OKV11 HEATER RHEEM CAM
New Electrical
Second Erfa etr
CONSTRUCTION INFORMATION:
Additional work to be performed
Mechanical
Electric
Gas Tank
Plumbing
Total 5q. Ft of Construction:
Cost of Construction: $
PLETE SYSTEM.
under this permit —check ail that apply:
has Piping
Sprinklers
Utz hies.
OWNER/LESSEE,0
Name CRO55ROADS CENTER PLC
Address; 10616 SOUTH US HWY 1
City: PORT SAINT LUC1E
State; �•
dip Code: �4�52 Fax:
Rhone No. 772-233-7007
E-Mail: JA8OB4007(pGMAfL.CoM
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
Residential
Lot No.
Block No.
_Shutters Windows/Doors Pond
Genera tar Roof Pitch
q. Ft. of First Fr or:
Sewer ___ Septic
CONTRACTOR:
Building Heist:
LUKAK
E WLER
Company: TREASURE COAST AIR
Address:-1055 S.W. MARTIN DOWNS BLUE)
City: STUART
State. �
Zip Code. 34990 I=x. 772-288-7046
P one No 772-692-1701
E- i@ i I T 1 0@ TT. ET/T V T
T. NET
If value of construction is 2500 o—r—
f a RECORDED Notice Of Commencement is requiIf value of HAVC is $7,500 or i
ore, a RECORDED Notice of Corn mence ent is required,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER. X Not Applicable MORTGAGE COMPANY': x Not Applicable
Name: Name:
Address:
City Stated.
i Zip: Phone
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
Address:
City'
ZAP Phone:
Address. -
City: State;
Zi P: Phone:
BONDING COMPANY:
Name:
Address;
City,
Zip: Phone:
x Not Applicable
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 t� the issuance of a permit.
5t. Lucie County makes no representation that is granting a permit wild authorize the permit hafder to build the subjecti structure
which is in corrtfict with any applicable Home Owners Association rules.,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homy Owners Assaciation and review your deed far any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in aE! respects, perform the work
its accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The f oif Sri ng b u iEdi ng perm it ap pI icati on s a re e xemt fro rn u nde rgo i ng a f u I I con cu rre n cy review:
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory
w►ArtNirvQ I U 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 pasted on the jobsite before the first inspection. It you intend to obtain financing consult
with d� n attorney before commencing work or recording _our Native of Commencement.
f
Signature of owner/ Lsee/Contractor as Agent for Qwner Signature of Contractor/4��ense holder
STATE OF FLORIDA STATE OF FLORIDACOUNTY OF ��f�T/�' COUNTY OF 1-1qR71&/
Sworn to (or affirmed) and subscribed before me of
�' Ph- ysica! Aresence or Online Notarisation
this � day of U k,f' 2020 by
A�1-z
�?/z -107
Name of person making statement.
Personally Known V/"'K OR Produced Identification
Type of Identification
Produced
Jl
(Signature of ary Pu 5*0-or
Mate f FR on
111,00
Commission No.
i
* } # 4 s
REVIEWS
-MZ7
wpm
}
FRONT 0
� +� �1 I
COUNTED +JAI
DATE
RECFIVED
DATE
COMPLETED
rev. 5/6/20'-
T-VE
11111111110
SVSOrr �� � pp
l i• � R
PI@
.5.
Sworn-�o(or affirmed) and subscribed before me of
�Physical Presence or Online Notarization
this day ofJ`IuA, 2020 by
Of
None of person making statemgnt,
rrll H '
Type of Identification
Produced
[signature
Notary P
UR rrocauce❑ iaenutication
is -State of Florida j
Oil .(Sea 1)
0
* }h * ■
0 0
f
PLATS E�IN SEA TINE
am-
REVIEWINR- RBI EW E I E1�
INN d
* # ..
Ot
nnarvGRovE
REVIEW