HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONo ya
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 04/27/2016 Permit Number:
BuildingNNED
Permit Application SC/BY
pp BY
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line M e C, tamb(FM
Address: 8630S-US HIGHWAY 1, PORT ST LUCIE, FL 34952
Legal Description: Legal Description -PLEASE SEE ATTACHMENT
PropertyTax ID #: 3414-501-1915-160-1
Site Plan Name: RACETRAC
Project Name: RACETRAC
Setbacks Front Back: _
Right Side: Left Side:
Lot No.
Block No.
Installation of Captive-aire Grease Hood, 1 Exhaust fan, 1 supply fan and connection of duct
dditionaiworKtob�,J
e_pe,Irrormea unaertnispermit—a
L
11HVAC Gas Tank ❑Gas Piping
Electric El Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 6600.00
I__IShutters ❑Windows/Doors
0 Generator 0 Roof
S Ft. of First Floor: _
Utilities. Sewer Septic
Building Height:
UVNERtESSEE�
�......3:,CONTRACTORz,y._,
d ��
Name RACETRAC PETROLEUM INC
Name: DAMES A WATSON
Address:229NE PEACHTREE ST #1900
Company: WATSON & COMPANY OF CENTRAL FL INC
City: ATLANTA State: GA
Zip Code: 30303 Fax:
Phone No.
Address: 16445 CR 455
City: MONTVERDE State: FL
Zip Code: 34756 Fax: 407-469-2186
Phone No. 407-469-2187
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: AMYMARINO@EMBARQMAIL.COM
State or County License: CAC1815558
If value of construction is 52500 or more, a RECORDED Notice or commencement is requireo.
SUPPLEIVIENTA�CONSTRUCTIOtV LIEN LAVU INFOftMATiON
"x 38 k '"}''
DESIGNER/ENGINEER:
Name:
x Not Applicable
MORTGAGE COMPANY:
Name:
x Not Applicable
Address:
Address:
City:
Zip: Phone:
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
x Not Applicable
BONDING COMPANY:
Name:
x Nat 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
rnmmencine work or recordine vour Notice of Commencement.
_ sVi a{ure of 06ner/ Lessee/Agent rSTATE
rmre or contractor
STATE OF FLORI /�, OF FLORIDA
COUNTY OF rWt OUNTY OF IAKE
The fo,r..g�oing instrum�egnt was acknowledged before me
this L day of NWT 201�by
-3a �s f,,e
(Name o person acknowledging )
5ture of\Notary Public -State
nally Known OR Prc
of Identifi uce _
Commission
Revised 07/15/2014
MY COMMISSI��AJFF185522
EXPIRES January 23. 2019
The forgoing instrument was acknowledged / �before me
this 47 day of APRIL , 20 L by
SAMfiS WAESn4
(Name of person acknow dging )
(SI nature of Notary ubl' - State of Fl9fricla )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. I rJ SeaI�NDALYNNIV
. NOTARY PUBLIC
Comm# FF163554
Expires 9/25/2018
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS