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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI ALL APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED q /� Date: �' / 0 ' I V SCANNED Permit Number. / 0 —(/-321 y- = St. Lucie County RECEWED Building Permit Application AUG 18 1016 Planning and Development Services Building and Code Regulation Division 2300 lrrginia 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 III Address: 100 Prima Vista Boulevard, Port St Lucie Legal Description: River Park -Unit 5 BLIK 50 w 10 it of Lot 17 and all Lots 18,19 and 20 (Parcels A & B) (Map 34 28N) (OR 2738-175) Property Tax ID #: 3419-540-0241-000-5 L� N 171819 20 Site Plan Name: National Gas & Oil Distributors #11917-Eleven #39250 Project Name: National Gas & Oil Distributors #119 Setbacks Front Bads Right Side: Left Side: o. Block No. WA remove dispenser island and dispenser sump, install new dispenser sump, new stainless steel island fann_aild concrete island. Install repla r�tent dispenser, connect and start up. 19 n - d U.e - n -; ot d (ern ctO e ck/v' h't + /J) . O + A to t P r' IIHVAC UGasTank ❑Gas Piping UShutters ❑Windows/Doors Electric 0 Plumbing ❑Sprinklers 1:1Generator Roof Total Sq. Ft of Construction: S Ft. of First Floor. Construction: of Consction: $ 57,900 Utilities, Ft Septic Building Height:- _ �©yU1��IER%L�SS,E'",,LLy•��� .:+'t'i.. 3�NA✓., uasi x4ti ,t;�� ��`a��CO.� L+a�I>>L.i A�.w'1.<J � �R ����1� :_ �,�`_"�� �;;�` Gre ...,. h'6Y. Name National Gas and Oil Distributors of Florida, LLC Wfafe Name: Donald W. Adams Address: PO Box 937 Company: Adams Tank & Lift, Inc. may Norfolk, State:VA Zip Code: 23501 Fax: Phone No.7b?-040-2135 Address. 4568 131st Avenue North City: Clearwater State: FL Zip Code: 33762-4106 Fax: 727-640.0848 Phone No. 727-540-0931 E-Mail: Hanover a@, nlleroiloo.com Fill in fee simple Idle Holder on next page ( if different from the Owner listed above) E-Mail: haroldhickcox@adamstankcom State or County License: PCC050767 If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required. Imo; IIerL_-C l� bX Uq o o J�cp � 71 I ec }+s d.a /e I -A 7 `� �a C� I VS10Y' 1`W."',N DESIGNER/ENGINEER: x Not Applicable Name: rrasypadd,aa.PEI'a*lEinin-faarx 4kLLc MORTGAGE COMPANY: Name- x Not Applicable Address: 12MEasrxsue4eaularaid.SuAD230 Address: City: Tampa State: A Zip: Phone: a1343"77o City: Zip: Phone- State: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: mme,auc BONDING COMPANY: Name: x Not Applicable Address: P0e=490%DW71t Address: City: se.na City: Zip: am, Phone: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit St. Lucie Count�yr makes no representation that is granting a permit will authorae the permit holder to build the subject structur which is in coMlict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit st 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 .IJI Ewa- L d . s 0wner/ Lessee, Agent Si r ture of Contra or/Ucense Holder STATE OF FLORIDA n STATE OF FLORIDA COUNTYOF Zn&arn I � COUNTYOF_ PLNELLAS The forgoing m ent was acknowledged before me this 'day of U Si 20 Icy i�cime.lcL �<`LI� (Name of person acknowledging) (Signaturb of Notary Public -State of Florida ) The forgoing instrument was acknowledged before me this Mclayof &ugLiAd- .20 by 'DenVAC) W. &Aarns (Name of person acknowledging) (SlWw otary ublio- tate of Florida ) Personally Known OR Produced Identification ✓ Personalty Known ✓ OR Produced Identification Type of Identification Produced 1'iDe1Lt'CLi-rge- Type of Identification Produced Commission No. I carp, ea PAMELA WEIXLELom P fission No. y �V`'ir'"•'a , JR. Notary Public •Slate of lorida HAROLD J. Notary Public • S HICKCOx Florida Commleslon # FF 198961 • commisslon # FF 07176E 'sf Revised 07/15/2014 7o �L• My Comm. Expires Feb 12, 2019 Bonded Through National Notary Assn �:wu tid,dAHmW,u»in,oru„m°. e,,., REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW _ _ _R EW REV)EW REVIEW REVIEW REVIEW DATE g COMPLETE INITIALS