HomeMy WebLinkAboutBuilding Permit Application 2-19-20All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 02i�� RECEIVEF-WeInit Nui
FEB 19 2020
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
PERMIT TYPE:
PRO.POSEO, I IVI PROVEMENT-LO:CAT10'N t'
Address: 7159 S US HWY 1, Port St Lucie, FL
Property Tax ID #: 3422-211 -001 0-000-6
Site Plan -Name:
Project Name: Existing Conidtion
I. D.ETAILED.'DESCRIPTI-O.N.OF WORK:
CHANGE OF USE TO RETAIL. CFA
CONSTRU.CTI'O N: I N FORMATIO:N. .
I. GWK
plkation -
Permitting Department
St. Lucie County, FL
Residentia
WIN
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic
Lot No._
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR: L
Name Port St Lucie 1, LLC
Name.WLIC
Company
Address:112 Phylis Ct
Address 53 Ib
City: Elmont State:_
Zip Code: 11003 Fax:
City: J State:
Phone No.954.966.8181
Zip Code:#�-
E-Mail:
Phone Now,. 61L--
Fill in fee simple Title Holder on next page ( if different
E-Mail f S t° 0.� •
from the Owner listed above)
State or Count License! C 1
11 value or conszruczion is >c5uu or more, a KtcvKOeo Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
`SUPPLEMENTAL,CONSTRUJ 7-1 LIEN LAW�IN.FO:RIVIATI. .
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: ReinaidoA. Gomez / AR#0013736
_
Name:
Address: 16oa7 sw 68st
Address:
City: Miami State: FL
City: State:
Zip:33193 Phone786.261.9551
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 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFO FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR A ORNEY B FORE RECORDING YOI}ft NOTICE OF COMMENCEMENT."
Sigifiature �FLORI
r/ Lessee/Contractor as A nt for Owner Spa of Contractor./Gc`erte Holder
STATE STATE OF FLORIDA
COU Y OF COUNTY OF_FR"t l Aeb
The forgoing instrument was acknowledged before me
this A3 day of A204,1) l34 20L by
7al�it.�Po%
Name of person makings tement.
Personally Known OR Produced Identification
Type of Identification ,,lV k"'. ? Armando Sardinas
.
Produced omn ssion # G0099306
-�` Expires: April 30, 2021
Bonded thru Aaron tJotaN
(Signature of Notary. tate of Florida )
Commission No. 6::'"v/ "_-w (Seal)
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
The forgoing instrument was acknowledged before me
this day of 20)LJ by
Name of pe n ma t
MAURO MAllELLA
Personally Known ° P of Florida
o€ Commission N GG 2737W
Ty a of Identifica n "9OF f� My Comm. Expires Nov 4, 2022
Produced ""BQAd@d through National Notary Assn.
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
SUPERVISOREVIEW R I REVIEW I PLANS VEGETATIEVIEWON I SEATURTEV EWLE I M EVIEWVE
l�