HomeMy WebLinkAboutBUILDING PERMIT APPLICATION}
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u
Date:' Qob 1 `5 Permit Number:
RECER'70l JUL 28 2015
SCANNED
Building Permit Application BY
Planning and Development Services I H 5'b St. Lucie Countv
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772) 462-1578 Commercial State University Residential
PERMIT APPLICATION FOR: Other - Gqs IM, V
Address: Florida Atlantic University, 5600 Old Dixie Highway, Fort Pierce, FL 34946, St. Lucie County
Legal Description: Florida Atlantic University, Harbor Branch Oceanographic Institute
Property Tax ID #: 1408-411-0001-000-4
Site Plan Name: HBOI Site Plan
Project Name: Harbor Branch Facilities Fuel Tank Replacement 2015
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
Removal of 3000 gal/3000 gallon gasoline/diesel dual compartment tank #14/15 DEP Facility ID
#8631107, STCM Account # 7247, Placard #451130 and replace with 2500/2500 gallon gas/diesel
dual compartment tank #22, STCM Account # 7247, Placard # Pending Je q,IS- IS "I) a
L_IGas Tank UGasPiping-ALJShutters
LlElectric El Plumbing ❑Sprinklers J�— LJ Generator
Total Sq. Ft of Construction: W� S Ft. of First Floor: _
Cost of- Construction: $ yl Utilities:SewerD5eptic
Windows/Doors
0 Roof
Building Height: -
OV�INEI2(LESSEE!,
;GONTEtAG7OR s
Name Florida Atlantic University, Dennis Zabel, Director EHBS
Name: Jason De Gaglia Sr., Project Manager
Address: 777 Glades Road, C069-112
Company: Glasgow Equipment Services, Inc.
City: Boca Raton State: FL
Zip Code: 33431 Fax:561-297-2210
Phone No.561-297-3129
Address: P.O. Box 10087
City: Riviera Beach State: FL
Zip Code: 33419 Fax: 561-842-7402
Phone No. 561-842-7236 a A 77. 1)3��
E-Mail: dzabel@fau.edu
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: Jason@glasgowequipment.com
State or County License: PCC045031
GI -I
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENfA"LCONSTRUCTION'Ii�N'LAW.INFORMATIQN
=.
:.,.
DESIGNER/ENGINEER:
Name:
xx Not Applicable
MORTGAGE COMPANY:
Name:
xx Not Applicable
Address:
Address:
City:
Zip: Phone:
State:
City:
Zip: Phone:
State: _
FEE SIMPLE TITLE HOLDER:
Name:
xx Not Applicable
BONDING COMPANY:
Name:
xx 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 Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencine work or recordine vour Notice of Commencement.
_ Signature �wner/ ee/Agent
STATE OF FLORIDA
COUNTY OF Px(m Bee
The for oing instr ent was acknowledged b fore me
this I day of 201by
person
M�
of Notary Public -State of Florida )
Commission No.
r-r aoo-T
Revised 07/15/2014
FF200797
STATE OF FLORID
COUNTY OF e�or�
The forgoing instrument was acknowledged ore me
thisg97dayofi 1 [ri 20 Eby
_ 7eer�--_/,v' - 4( ,
(Name of person ackno_wle7Lging )
Commission No.
{:7%/7?XV
of Florida )
Jd@Ml ' ALEXIS
My COMMISSION #FF178880
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