HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number �Oa �Ca�y
S`Lc
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:
P`RfJP E SED IN PRQUivMENT I- CATJQN
r r .�
Address: 7526-7532 US HWY 1. St. Lucie County, FL 34952
Property Tax-11) #: 3422-86$-0001-000-7 Lot No.
Site Plan Name: Prima vista crossings Block No.
Project Name: Accelerated Learning Center
Alteration level 2 renovation of (4) existing strip plaza bays. This includes selected demolition of (2) built out bays and the renovation of (2) existing bays
The work will include, framing, electrical, mechanical, plumbing, and normal interior finishes. This work shall not extend beyond the envelope of the
of the existing building.
New Electrical Meter Second Electrical Meter (Affidavit required)
Additional work to be performed under this permit —check all that apply:
XMechanical _ Gas Tank _ Gas Piping _ Shutters
X Electric X Plumbing X Sprinklers
Total Sq. Ft of Construction: 5,740
Cost of Construction: 19�J D
Generator
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer _Septic Building Height:
y," (y Y 1 # � ECn3'" R ,d,✓`iEv �� .� #d ;i= � f 9 ':
F. " n. + �,FL } 4ti � $ � P f � d34 i i £T t; '""' ,.
Name Accelerated Academies, LLC
Name: Mark W. Burch
Address: 910 W Van Buren, Suite 315
Company: Green Building Construction Corp.
City: Chicaao State: IL
Address: 2885 Jupiter Park Drive, Suite 1800
Zip Code: 60607 Fax:
City: Jupiter State: FL
Phone No. (334) 488-6591 E-
Zip Code: 33458 Fax:
Mail: sbarlow@accelerationacademy.org
Phone No (561) 747-9433
E-Mail mburchgbcc(a_att.net
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License CGC 1520894
It value or construction is Z500 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.
1
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UPRI� MEI�TAS GE3NS:TRUGT 01 t"N't 1(lN QRM/�TIC3N _ � �
_ � �..x. >,.eEx ,. ? �„'�� :�� n.,.wd�
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
x Not Applicable
Name: Thomas T. Cooper
Name:
Address: 4498 NE Skyline Drive
Address:
City:
State:
City: Jensen Beach, State: FL
Zip: 34957 phone (772) 232-1767
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY:
x 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 attornev before commencing work or recording vour Notice of Commencement.
•i��l`'��/�� � � �✓ cam/`' _
Signature of Contractor - or - Owner Builder as applicable
STATE OF FLORIDA
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COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this Z,� day of 20 2-2-by
Name of person making statement.
Personally Known _9 OR Produced Identification
Type of Identification Produced
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(Sign Va of n.tary Public- State of Flor' a)
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011qG,
Commission No. (Seal)
JACQUELINE AYERS
:o`'R `k!, Notary Public -State of Florida
®� Commission @ HH 197749
, My Commission Expires
nnm� November 11, 2026
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Rev 10/12/21