HomeMy WebLinkAboutAPPLICATION FOR BUILDING PERMITSEWER: I &1 ° ,'I.(� ; SPRINKLERS I I STORMWATE
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DATE FILED: v
PLAN REVIEW FEE: 00 O RECEIPT NO.: PERMIT NUMBER: (9
CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. Nn__ /1717/1
ALL INFO MUST BE COMPLETE 8t FILLED IN TO BE ACCEPTED
„y yam, ST. LUCIE COUNTY PUBLIC WORKS
co BUILDING & ZONING DEPARTMENT
2300 VIRGINIA AVENUE
'Pl0R10P FORT PIERCE, FL 34982-5652
772-462-1553
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
LOCATION/SITE ADDRESS: 3101 Industrial Avenue #3 Fort- Pierce, Fr 34946
S/D NA -ME: Airpzsr�> ndt� pia par ITEPLAN NAME: Classic Truss Co Inc
00,
PROPERTY TAX ID#: 1 429_501 _0042_000-4 004-1-0 0-1 —AAZS rinn �,
LEGAL DESCRIPTION (attach extra sheets if necessary): Lots 2, 18, 19 & 20 Block 3 according
to the Plat of Airport Industrial Park, Unit. One, Plt Bk 12, Pg 40
5. PLAT. 6. PAGE 7. BLOCK 8. LOT .
BOOK 12 NO. 40 NO. 3 NO. 2, 1 8, 1°, 2 0
9. PARCEL SIZE: ACRES/SQ FT. 4.87 LOT DIMENSIONS
10. DESCRI
PTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: PRODi7CTTON BLDG / N
9L- T a n
11. SETBACKS (ACTUAL) FRONT: BACK: RIGHT LEFT
70 176 SIDE 85 SIDE: 25
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
[ ] NEW CONSTRUCTION [x] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[ ] RESIDENTIAL [ ] COMMERCIAL ] INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE: OOF, TRUSS_ MA,JUFACTURER
14. Sq. Ft./CONSTRUCTION: r , 15. Sq. Ft. 1 st Floor: N / A
16. VALUE OF CONSTRUCTION: $� 1-0,to
The value of construction is used to determine the amount of permit fees to be assessed. St. Lucie County reserves the right to question and/or modify the
indicated value of construction if it is demonstrated that the submitted figures are not oohsistent with similar types of construction activities. If the value is $2500
or more, a RECORDED Notice of Commencement must be submitted with this application.
. NO
SLCCDV Form No.: 001-02
OWNER INFORMATION:
NAME:
ADDRESS: 3101 Industrial Ave #3,
CITY: Fort Pierce STATE: FL ZIP 34946
PHONE (DAYTIME): (7-7-1-4-6-6=7_21-9 It LG ' I2'L4
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS
BELOW.
FEE SIMPLE TITLEHOLDER:
ADDRESS:
CITY: STATE: ZIP
PHONE (DAYTIME): ( 1
CONTRACTOR INFORMATION
_
ST. of FL REG./CERT #:
C &G • S9' 4 o4 ST. LUCIE COUNTY
I a
CERT #:
!n1I
BUSINESS NAME: a
za
QUALIFIERS NAME:
t
o J A
ADDRESS:
1521 nn 1 1 wnotJ R 1 yrl
CITY:
Loxaha t chee
STATE: FL
- ZIP- 3 3 4 7-0 --
-PHONE-(DAYTIME):
( 5 6-11 71 91 7 6 3
FAX NO.
ARCHIT/ENGINEER:
Tnnnvative Tn 11 Jeri Uhran
ADDRESS:
_505 Kansas\Wood Court
\
CITY:
tl de
STATE:
FL ZIP 3 2 8 2 4 1
;
PHONE (DAYTIME):
(77.A 407-438-3008.
BONDING COMPANY:
ADDRESS:
=,
CITY:
STATE:
ZIP
MORTGAGE LENDER:
_Gulf -stream Bu ine s Bank
ADDRESS:
2400 Monterey Road
j
CITY:
Stuart
STATE: FL
ZIP 32824
IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60 days
after notification it will be voided and returned to you by mail.
CERTIFICATION:
This application is hereby made to obtain a permit to do the work and installations as indicated, and to obtain a certificate of
capacity, if applicable, for the permitted work. I certify that no work or installation has commenced prior to the issuance of a permit
and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that
separate permits may be required for ELECTRICAL, PLUMBING, SIGNS;' WELLS, POOLS, FURNACES,- BOILERS, HEATERS,
TANKS, AND AIR CONDITIONERS, ETC., not otherwise included with this building permit application.
The following building permit applications. are exempt from undergoing a full concurrency review: room additions, accessory
structures (all types), swimming pools, .fences, walls, signs, screen rooms, utility substations & accessory uses to another non-
residential use.
NOTICE TO OWNER: .FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT.
NOTICE TO APPLICANT: AS THE APPLICANT FOR THIS BUILDING PERMIT, IF IT IS NOT YOUR RIGHT, TITLE, AND
INTEREST THAT IS SUBJECT TO ATTACHMENT; AS A CONDITION OF THIS PERMIT YOU
PROMISE IN GOOD FAITH TO DELIVER A COPY OF THE ATTACHED CONSTRUCTION LIEN
LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be clone in"compliance
wi h licable laws regulating construction and zoning.
O ONTRACTOR SIGNATURE CO TOR SIGNATURE
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF TL
The foregoing instrument was acknowledged The foregoing instrument was acknowledged
before me this L-- day of -�N,Q, 20�, by _ before me this n - day of "3u,, , 20'" , by
�a Qwho is personally known to me or who h ' V\IA �, who is personally known to me
has produced as identification. or who has produced _ uR"Outification.
Signature of Notary \� � ,s%oH expo, i Signature of Notary o �• �� �� 20 �*
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Commission Num �bjj��� ���°`1111���\ Commission Num
(seal)
(seal)
NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED.
IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR
TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION. .