HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLEJNFO MUST ccB��E COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /21 ' �1S' l Permit Number: �I �� — t/y LC T ►
RECEIVED
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Building 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: Interior Build out
PROPOSED IMPROVEMENT LOCATION:
MAR 18 2021
Permitting Department
St. Lucie County
Address: 5180-5182 Turnpike feeder road Ft Pierce FI 34982
Property Tax ID #: 1301-615-0079-000-9 Lot No. 18-20
Site Plan Name: Lake Park Plaza Block No. 171
Project Name: Mi Tierra Latin Store
DETAILED DESCRIPTION OF WORK:
Interior build out. installing New Framing, Drywall, M EP, new flooring.
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
V Electric / Plumbing _ Sprinklers _ Generator
_ Windows/Doors _ Pond
Total Sq. Ft of Construction: 1264 sq. ft Sq. Ft. of First Floor:
Cost of Construction: $ 65,000 Utilities: —Sewer _ Septic Building Height:
Roof Pitch
OWNER/LESSEE:
CONTRACTOR:
Name Noe Gamez,lbeth Gamez
Name: Michael Waldrop
Address: 2606 S 17th ST
Company: Innovation Contracting
City: Fort Pierce FL State: _
Address: PO Box 12757
Zip Code: 34951 Fax:
City: Fort Pierced State: FL
Phone No.
Zip Code: 34979 Fax:
E-Mail:
Phone No 772-519-9108
Fill in fee simple Title Holder on next page (if different
E-Mail Mwaldrop@innovationContracting.com
from the Owner listed above)
State or County License CGC151191:0
it vawe or construction is cauu or more, a KtwKULU Notice of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
I
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
improvemen s to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie Coun and posted on the jobs ite efore the first inspectio . If you intend to obtain financing, consult
with len r or an attorneybef ommencin work or recordi our Notice of Commencement.
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;SUPPLEiVIENTAL
CONSTRUCTION
LIEN LAW
INFORMATION =
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DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Sign ure o ner/ Less /Co tractor as Agent for Owner
Si ure o ntractor/Lice s er
STATE OF
OF
STATE OF FLORI
OF �� LLLC,t�
COUNTY
COUNTY
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 . 2020 by
this of by
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Name of person making statement.
Name of person making statement.
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Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Publ�ie of��W �Ct,�ph®,;1
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