HomeMy WebLinkAboutBUILDING PERMIT APPLICATION�I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/20/2015 SCANNED Permit Number:
- - — BY
St. Lucie Counry
RECEIVED
Building Permit Application
Planning and Development Services OCT 9 () 2015
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial z(Public Facility) Residential
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I
PROPOSED IMPROVEMENT LOCATION:
Address: 40392 Southbound 1-95, Fort Pierce, FI 34947
Legal Description: St Lucie County Rest Area (North Bound)
Property Tax ID#: t73—/%/-0(Y00'
Site Plan Name,
Proiect Name: 433963-1 St Lucie County Northbound and Southbound rest areas
Setbacks Front Back: Right Side: Left Side:
DETAILEDOESCRIPTION •OF.WORK:- III
INSTALLATION AND OPERATION OF A TEMPORARY BATHROOM TRAILER. TRAILER WILL
INCLUDE TEMPORARY ELECRICAL SERVICE WITH LOAD CENTER. TRAILER INCLUDING ALL
PIPING, SIGNAGE, AND PATCHWALLS WILL BE(R EMOVED AFTER REST AREA TOILET ROOMS J'
ARE BACK ONLINE. /(/fyt�s j �� 0 Zi )cIF, M r1%j�!s
CONSTRUCTION INFORMATION:
itinna uinr to ono nrmar1 un crt is normit—r or a t at ann v
LJHVAC Gas Tank
Electric Plumbing
Total Sq. Ft of Construction: 4323
Cost of Construction:$ 20,000
Gas Piping UShutters Windows/Doors
Sprinklers 1:1 Generator E Roof
S�Ft. of First Floor: 4323
Utilities:2Sewer ]Septic
Building Height:
-OWNER%LESSEE:
'CONTRACTOR.`-
Name Florida Departmentof Transportation (District4)
Name: John Davis
Address:3400 W Commercial Blvd
Company: IMECO, inc
City: Ft Lauderdale State: F1
Zip Code: 33309 Fax:
Phone No.954-486-1400
Address: 20030 E Oakmount Drive WOW
City: Hialeah I
Zip Code: 33015 x;
Phone No. 954-699-5705
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner li ted abovel
WEND — l
E-Mail: nAS-60 6!9Z, Kit
9
State or County'License: CC C[
1!,value of constA.ction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.
DESIGNER/ENGINEER: _ Not Applicable
Name: Michealw.Pdory
Address: 3230 West Commercial Blvd, Suite 100
City: Fort Lauderdale State: n
Zip: 33309 Phone: 954-733-7233
FEE SIMPLE TITLE HOLDER:
Name:
Address:
-City:
Zip: Phone: _
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
Zip: Phone:
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, 1 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
commencin work or recordin our Notice of Commencement.
s
_ Signature O nerner Lessee/Agent Si a ure Contractor/License Holder
STATE OF FLORIDA� 0 1_ ORIDQ�
COUNTY( u C=t COUNTY OF� ;tjre
The fgSgging instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of f�C�LD • 20 �y this day of ��Sp�C7af 20 L by
(Name of person acknowledging) (Name of person acknowledging)
State
Commission No.1313,9—,2—
Revised 07/15/2014
Notary Put
My Comm.
Yr� w_A5 (Signatu a of Nota Public- State of Florida )
# FF
``-LUkKA M WLVA
MY OOMMISSION aM EE14
EXPIRES November 17. S
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