HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONl�
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater 3/21/2016 SCABNNED Permit Number:tond-
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r St. LucieCGunty RECEAVD
Building _ Permit Application APR 2 5 2016
Planning and Development'Services r^I„�di PERMITTING
T�C�
Building and Code Regulation Division TV St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Alteration
,PROPOSED 1MPROVENIEN i LOCATION:
Address: 7131 S US HWY 1, Port St. Lucie FL
Legal Description: 22 36 40 BEG AT SE COR OF NE 1/40F NW 1/4 RUN S 27 DEG 38 MIN E 210 FT TO N LI
OF RIO MAR DR, TH 5 62 DEG 22 MIN W 30 FT, TH N 27 DEG 38 MIN W 225.83 FT, TH N 89 DEG 49 MIN W 555.72 FT MIL, TH N 00 DEG 07 MINE 800 FT, TH 5 89 DEG 49 MINE
Property Tax ID #: 3422-211-0010-000-6
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
1. Asbuilt drawing for non load bearing installation and stage platform.
Will get engineer inspection on wall construction and electrical
Lot No.
Block No.
�HVAC
U Gas Tank
Gas Piping
UShutters
❑
Windows/Doors
IIElectric
Plumbing
[]Sprinklers
Generator
Roof
Total Sq. Ft of Construction: 900 00
Cost of Construction •00 rl �,L
Sq. Ft. of First Floor: 1160
Utilities: Sewer 0Septic
Building Height:
DOWNER/LESSEE
f n r
CONTRACTOR
Name Port St Lucie Plaza I LLC
Name: Roderick Waller
Address:112 Phylis Ct
Company: Sunrise City CHDO, Inc.
City: Elmont State: NY
Zip Code: 11003 Fax: 7
Phone No. %� 2/ 3
Address: 800 Virginia Ave Suite 61
City: Fort Pierce State. FL
Zip Code: 34982 Fax: 772-907-0420
Phone No. 772-201-2850
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: rodwallerl@gmaii.com
State or County License: CGC1515114
It value of construction is $250D or more, a RECORDED Notice of Commencement is required.
`SU�PLEMEAt7kLaCONSTRUCTION
LIE(LAW INFORMATION a
DESIGNER/ENGINEER: _
Name: 4 C
Not Applicable
MORTGAGE COMPANY.
Name:
Not Applicable
Address:
O
Address:
City: 0
Zip: 'alig M6Y& Phone:
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
_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 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, 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
_ Signa ure of Own+ / Lessee/Agent
Signature
STATE OF FLORIDA 1 STATE OF FLORIDA
COUNTY OF LUojI r. COUNTY OF
The forgoing instru ent was acknowledged before me The for oing instru ent was acknowledged before me
this day of 20 )by this -7 day of 20 by
F1 P,rin,ll f 9wl�er Ap.lri ik WNI�.
(Name of person acknowledging ) (Name of person acknowledging) _
of Notary
(Signature of Notary Public- State
Personally Known 11 OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced J—1 Type of Identification Produced R , D.1 ,
Commission No. NIELSEN mmission No. r Seal
ENS.
°.; .
e Commission # FF 11563 KAREN S. NIELSEN
,,;;o°, June 12, 2018 Pam; My Commission Expires
Revised07/15/2014 ''%'°°°; June 12, 2ote
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