HomeMy WebLinkAboutPermit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/19/2021 Permit Number:
L TC
ti 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 CBDG Funding
PERMIT APPLICATION FOR: 7-ELEVEN
PROPOSED IMPROVEMENT LOCATION:
Address: 7310 Indrio Rd Fort Pierce, FL 34951
Property Tax ID #: 1314-144-0000-000-0 Lot No._
Site Plan Name: Block No.
Project Name: 7- Eleven
I DETAILED DESCRIPTION OF WORK: I
Emergency Replacement of 3 Backflows
(1 ) BACKFLOW MODEL 975 XL 1" AND( 1) BACKFLOW MODEL 975 XL 1 1/2"
( 1 ) SERIAL 800 M401' 1/2
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors __ Pond
_ Electric Y Plumbing _ Sprinklers _ Generator _ Roof _ Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 3,900.00 Utilities: _ Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name INDRIO RETAIL PROPERTIES LLC
Name: Joshua B Weinstein
Company: JW PLUMBING CO
Address: 2129 VIA FUENTES
City: VERO BEACH State: FL
Zip Code: 32963 Fax:
Phone No. E-
Address: 5829 Rodman St
City: RODMAN ST State: FL
Zip Code: 33023 Fax: 954-987-5856
Phone No 954 485 5583
E-Mail davidjwp@hotmail.com
State or County License CFC1428728
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:
_ Not Applicable
State:
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 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.
Signature of Oky&l Aee/Contractor as Agent for Owner
STATE OF FLORID
COUNTY OF
Sworn t(or affirm a d Jsbscribed before me of Physical Presence or Online Notarization
this day of YV" 20 ZI by
e of person making statement.
Personally Known OR Produced Ide tification
Type of Identification PrpduS0_ 7 �
,signature of Notalffuf ic- State of Florida)
xe-,"
NOEMI PEREZ
Commission No.U2U��(Seal)MY COMMISSION#HH020450 EXPIRES.- August 23, 2024
FOF c Q. Bonded Ttvu NWay Public Undenvrkars
REVIEWS FRONT j ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLET
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SUPERVISOR I PLANS I VEGETATION SEA TURTLE 1 MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW