HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number,99/ /
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial X Residential
CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED .IMPROVEMENT LOCATION:
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Address: 5780 Indian Pines Blvd., Ft Pierce, FL 34951
Property Tax ID #: 6238 1407-223-0001-000-4 Lot No.
Site Plan Name: Holiday Pines (F.K.A. North County) Wastewater Treatment Plant Block No.
Project Name: North County Service Area Repump Station
DETAILED DESCRIPTION OF WORK:
Construct new submersible pump station, generator and new power service with associated force mains.
New Electrical Meter X 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
.)L Electric _ Plumbing _ Sprinklers X_ Generator _ Roof Pitch
Total Sq. Ft of Construction:—10,000 sqft Sq. Ft. of First Floor: —650 sgft
Cost of Construction: $ 678,000 Utilities: jC Sewer _ Septic Building Height: N/A
OWNERAESSEE:
CONTRACTOR:
Name St Lucie County BOCC
Name: Jeffrey Watson
Address: 2300 Virginia Ave
Company: Centroid Diversified, LLC
City: Ft Pierce State: EL_
Address: 254 NE Surfside Ave
Zip Code: 34982 Fax: (772)462-1704
City: Port St Lucie State: FL
Phone No. (772)462-1700 E-
Zip Code: 34983 Fax:
Phone No (850)791-2038
Mail: ciminod@stlucieco.org
Fill in fee simple Title Holder on next page (if different
E-Mail ieff.Watson@centroid-diversified.com
from the Owner listed above)
State or County License FL CGC1511908
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
MORTGAGE COMPANY: X Not Applicable
Name: Masteller & Moler, Inc.
Name:
Address:
Address: u55 27th st, spite 2
City: Vero Beach State: FL
City: State:
Zip: 32960 Phone (772)567-5300
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name: JCA Surety
Address:
Address: 123 Zelma St., Suite A
City:
City: : Orlando
Zip: 32803 Phone: (329) Roo-6s%
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 attornev before commencine work or recordine vour Notice of Commencement.
Sign ner/ ssee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF1
Sworn tQ (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this �dayof lJ[SV .207�— by
Name of person making statement.
Personally Known OR Produced Ide ification v
Type of Iden ification Produced
(Signature of Notary Public- State of Flo i a)
SP 0 ��
o`'i<'r'"''� 7HEATHER BURFORD
°_Slorida-Notary
Commission No. (Seal) _2°
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sion #/ GG 183217 i'JF,
pF F�°QOP` My Commission Expires
February O 2022
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