HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ` f
Date: 9-22r2'i 7, Permit Number: 0 - ow S� �-
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Building Permit Application
Planning and Development Services 03AI3038
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
iIPRsQP�Q ED�I'MPRC VEIVI`ENT LOCATION i }i ;i'I'i,
Address: 4892 Kings Hwy, Fort Pierce
Property Tax ID #: 1313-232-0001-000/4 Lot No.
Site Plan Name: AutoZone Store Block No.
Project Name: AutoZone Store
New Electrical Meter Second Electrical Meter (Affidavit required)
1:!C6NaS= +RUCTION!INiFORMATI'ON
I1 Flu �I�1 H IIII i ti f 1 _ 4
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
X Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1500 Utilities: _ Sewer _ Septic Building Height: 1
01NNER%LESSEE I!,,;,! j j,, ;
CONTRACTOR:
Name Noth Kings Highway LLC
Name: Israel Garcia
Company: Integrated Technologies Inc
Address: 975 N Miami Beach Blvd
City: North' Miami State: FI.
Address: 10773 NE 58th St
Zip Code: ' ll1 Fax:
City: Miami State: FI
Phone No.. E-
Zip Code: 33178 Fax:
Mail::
Phone No 786-370-3570
Fill in fee simple Title Holder on next page (if different
E-Mail_ _ israeWiteckm.com
State or County License FF-0001194
from the Owner listed above)
IT value of construction is 2500 or more, a RECORDED Notice of Commencement is required.�� r
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. 1
I
S,UPIPLEMENT�LICIOINSTRUCTION�LIEN LAW;INFORMIATI.ONi
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:
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 O ER: Your failure to Record a Notice of Commencement may result in paying twice for
improveme o your property. A Notice of Commencement must be recorded in the public records of St.
Lucie Coun � d posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lende o n attornpv before rnmmpnrina wnrk nr rprnrrlino vniir Nntirp of rnmmpnrpmpnt
Signature o n r/ Lessee/Contractor as Agent for Owner
STATE• OF, FLORIDA
COUNTY OF ' ;C9�
Sworn -to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 20y
r ,
Israel Garcia
Name of person making statement.
Personally Known OR Produced Identificaa �[on L�
Type of Identification Produced
(Signature.. of Notary Public- State of Florida)
GISELA BONET
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Commission No 6'4 �t",��ySeal
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_° `�- State of Florida -Notary Public
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_* *_ Commission # GG 146225
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OFF\c\�` My Commission Expires
',II++` September 26, 2021
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