HomeMy WebLinkAboutBUILDING PERMIT CHECKLIST17L_
ALL APPLICABLE INFO MUST BE COMPLETED FO&UPNLICATION TO BE ACCEPTED
Date: A WED PermitNumber;
BY
St. Lucie Countv
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i� Building Permit Application ec,
Planning and Development Services RE. C EF I
Building and Code Regulation Division VED
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X ReMeAfA12015
PERMIT APPLICATION FOR: Alteration St. Lucie county, FL
PROPOSED IMPROVEMENT LOCATION:
Address: 7620 S Us Highway I
Legal Description: Prima Vista Number One (PB 40-37) lot 1 (1.64 AC) (OR 1547-477)
PropertyTaxlD#: 3422-802-0004-0040_5 Lot No.
Site Plan Name: Block No.
Project Name: Walgreens - 5335 - FY1 5
Setbacks Front Back: — Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Interior remodel to approx. 175sqft of existing space adding one consultation room, modification of
existing ME systems to accommodate new and existing spaces.
II I
CON TRUCTION INFORMATION:
lonal worR tonenerrormea
under
this permit — check
all apply
ZHVAC
F]GasTank
[:] Gas Piping
—Shutters
[n
Windows/Doors
ZElectric
1:1 Plumbing
E]Sprinklers
0 Generator
Roof
Total Sq. Ft of Construction: 175
S Ft of First Floor:
Cost of Construction:
$ 15,000
Utilities .11 Sewer OSeptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name.Walgreen CO
Name: \-\O�AX
Address: 106 Wilmot Rd.
company: Hooks Construction
City: Deerfield State: I L
Zip Code: 60015 Fax:
Phone No. (847) 315-4717
Address- 2211 S. Kanner hwy
City: Stuart State: I L
Zip Code: 34994 Fax:
Phone No. (772) 419-8828 7 �t95—
E-Mail: thomas.wilson@walgreens.com
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
E-Mail: steve@hooksconsfruction.net
State or County License: 6co6uo
11 It value at construction is $2500 or more, a RECORDED Notice of Commencement is required. A,5'j� 2- 0 11
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x NotApplicable
Name: Kyle C. Davis - Gensler Associates
MORTGAGE COMPANY:
Name:
X Not Applicable
Address: 11 E. Madison St. Suite 300
Address:
City: Chicago State: IL
Zip: 60602 Phone: (312) 456-0123 -
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY:
Name:
X Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: _ Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in cc Yict with any applicable Home Owners Association rules, bylaws or and covenants that ma estrict or prohibit such
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structure. Please consult with your Home Owners Association and review your deed for any restrictions Yhri h may apply.
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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 jobsite
before the first inspection. If you. intend to obtain financing, consult with lender or an attorney before
,:. �::;' "i, '�� <, 4-%--
?9�i—afure of Owner/ Agent/ Lessee Signature of Contractor/License Holder
STATE OF FLOR112 STATE OF FLORIDAW
COUNTY OF 11 t COUNTY OF eb'k-)
mgtnstruMgnt was acknowledged before me
The ing instLument was acknowledged before me The f
J
thisizday I'dlill1f 20 -W by this 7rday of I LuH 26_jfby
—T'4amo-i w%�%ur4
(Name of person acknowledging
Personally Known
Type of Identification Prock
Commission No.
Revised 07/15/2014
of Notafv/Publir- State of Florida
n Personally Known - I/ OR Produced Identificaticil
Type of Identificati
HOWIMODY
NGRI�,M OFFMANN Commission No. Z Notary pu ate of Florida
I YPU �STATE OF ILLINJ
7TAR
Y COMMI 10 SXP S 09103 CIS
IRE 16 Z My Comm. Expires Dec 16, 2011
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