HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -
Permit Number: - oo
Date: SCANNED
By
St. Lucie Countv HEMVEJ
Building Permit Application DEC 2 8 2016
Planning and Development Services - PER?AITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1579- Commercial X Residential
I PERMIT APPLICATION FOR: Electrical 1-1 111
Address: CVS, 4780 N Kings Hwy, Ft Pierce, FL 34951 -
Legal Description: 13 34 39 S 258 FT OFE 291 FT OF W 362 Ft OF NW 1/4 OF SW 114 (1.72 AC) (OR 1126-1398)
Property Tax ID #: 1313-322-0002-000-7 Lot No.
Site Plan Name: CVS Block No.
Project Name: CVS, 4780 N Kings Hwy, Ft Pierce, FL 34951
Setbacks Front Back: _ Right Side: Left Side:
Replace existing drive up equipment
_J Gas Tank
Z Plumbing
Total Sq. Ft of Construction:
Cost of Construction:$
Piping
U S*hu'tters
E]Windows/Doors
nklers
1:1 Generator
0
Roof
=
Roof pitch
S Ft of First Floor:
Utilities SewerF]Septic
Building Height:
�,E
NameCVS
Name: Anton C Rochek
Address: One CVS Dr
Company: The Platinum Group Inc
City: Woonsocket State:Rl
-ZipCode�02895- —Fax'--
Phone NO.
Address: 733 Commerce Dr, Ste 3
City: Venice State: FL
Zip Code: 34292 Fax: 941-488-5203
Phone No. 941-484-1213
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: k(istina.rohl@theplatinumgroupinc.com
State or County License: ECO001 672
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: X NotApplicable
Name:
Address:
City: State;
Zip: Phone:
BONDING COMPANY: x NotApplicable
Name:
Address:
City: —
Zip: —
I certify that no work or installation has commenced priorto the issuance of a permit.
Phone:
St.LucieCoun makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
trict with any applicable Home Owners Association rules, bylaws or an covenants that may restrict or prohibit such
which is in con, I x
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 Cocf�s and St. Lucie County Amendments.
The following building permit applications are exdrript 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
commencing work or recordig your Notice of Commencemenv 4 on if
I FT PIE=PRO7PRTIES LIMWD PARTNERSHIP, LLP
BJ:.
LA 0 ORGANIZ ON, INGLPAITED PARTN�R AAAAA- 0 A� JV- -L
as
STATEeFfLORIIBA COMMONWEALTH OF VIRGINIA
C0bf*Ty-(x- CITY OF VIRGINIA BEACH
The forgoing instrument was acknowledged before me
this_SX11dayof nFcFmnFg 20 -ifby
s
Signature of Contractor/License Holder
STATE OF FLORIJDA
COUNTY OF 2 LfA*sVrA-
The forgoing instripea was acknowledged before me
this?V day of L= 20 _[� by
(Name of person acknowledging) (Name of person acknowledging)
Known A OR
Type of Identification Produced_
Commission No."'70) 14 -7 D3 -7
Revised 07/15/2014
ci�-- "
(Signatdre of Notary Public- State of Florida
Personally Kri-own OR Produced Identification
3)tpp of kk4giftlafflon Prtd ed F-- —
Nota,%ubll State of Florida
Commission No. Co !iMl FF 199353
1 MY COMM. e*feS AP(11 22,2018
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