HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: 1704-0138
• SCANNED
Building Permit Application 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
P.ERMITAPPLICATION FOR: Building
PROPOSED 1IMPRQVEMENT LOCATION;
Address: SW corner of NE Prima Vista Blvd and SE Floresta Drive
Legal Description: Lots 1, 2, 3, 4, 5, 46, 47, 48, 49, and 50, Block 45, River Park- Unit 5, according to the plat or map thereof
As recorded in Plat Book 11, Page 31, Public Records of St. Lucie County, FL
Property Tax ID #: Lot No.
Site Plan Name: Block No. 45
Project Name: Wawa #FLO (Dumpster Enclosure)
Setbacks Front 193.8' Back: 131.8' Right Side: 100.8' Left Side: 131.8'
DETAILED.DESCRIPTION' OF WORK:
Construction of Wawa Dumpster Enclosure
CONSTRUCTIO,M ,IN FORMATION:
tiona work to e e orme under tis permt—c ec
�HVAC besTank []Gas Piping
a appy:
_Shutters
❑Windows/Doors
Electric El Plumbing
❑Sprinklers
[]Generator .
Roof Roof pitch
Total Sq. Ft of Construction:
S'C Ft. of First Floor:
Cost of Construction: $
Utilities:
Sewer Septic
Building Height:
OWNER/L SSE
CONTRACTOR:
Name Wawa Florida, LLC
Name: Steven C. Hooks
Address:7022 TPC Drive, Suite 200
Company: Hooks Construction Cc
City: Orlando State: FL
Zip Code: 32822 Fax: n/a
Phone No. 610-358-8000
Address: 2211 South Kanner Highway
City: Stuart State: FL
Zip Code: 34994 Fax: 772-237-3757
Phone No. 772-419-8828
E-Mail:—
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: steve@hooksconstruction.net
State or County License: CGC #061217
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SLiPPL =LW0' STRl1C71301LI RN L CNFO
M ION
—
_..
DESIGNER/ENGINEER: _ Not Applicable
N a m e: wawa Florida, PLC
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address: 7022 TPC Drive, suite Zoo
City: odando State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 authorizethe 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
commencing work or recording your Notice of Commencement.
Si nature a Owner/ Less jcontractor as Age Tfor Owwne
Signature of Contractor/License Holder
STATE OF P¢KKsiIV&WZ C -
STATE OF FLQRIDA
COUNTY OF N, •_0__
COUNTY OF [-lGrliv,
The forgoing instrument was acknowledged before me
The forgoing inst ument was acknowledged before me
this & ^day of fie tAw.hcr 20_a by
this day of 201a by
Ty't . E ti1,�1c�;,,�.
Ii :XIC
Name of persona aking statement
✓✓
Name of per on making statement
✓✓
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
• TH OF FMNSWVANN
............. .
(Signature of Notary P k—,State of L SEAL
ignature of Notary Public- 'jftd taryPo6lic-state of Florida
IWIENII EL BAIOCCO
commission eGeo72280
Commission No. No
EIONTS:967fO,DELAWARECOUNTY
Commission No. `ti?,Fa . WEExpires Feb 12,2021
•..,.,,'„ m� `ed iR,oughNffianalNNaryAcvt
My Comtnll;8106 Expites Doe 28, 2018
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RECEIVED
DATE
COMPLETED
Rev. 8/2/17
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: Permit Number: r7o 4. 01_� /tO
Building Permit Application
Planning and Development Services
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: Building III
PROPOSED IMPROVEMENTLOCATION:
Address: SWC of NE Prima Vista Blvd & Floresta L
Legal Description:
Property Tax ID ti: 1 Lot No.
Site Plan Name: INl�,m) Block No.
Project Name: Wawa 4FLO (Dumpster Enclosure)
Setbacks Front Back:_ Right Side: L Left Side: _yC
DETAILED;D,ESCRIPTION OF WORK:
New Construction of Wawa Dumpster Enclosure
CONSTRUCTION INFORMATION:
rtiona war to e e orme under tispermit-check all apply:
11HVA1 Gas Tank ❑Gas Piping _Shutters Windows/Doors
❑✓— Electric ❑✓_ Plumbing Sprinklers Generator Roof = Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 27,400.00
S Ft. of First Floor:
Utilities:Sewer 11Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 25/0 P
LLC.
Name: TBD
,t
Address: 10. �w&AYI /�U4-- SUl6c7DC
Company:
City: F"&V O` State:FL
Zip Code: 33609 Fax:
Phone No. %
Address:
City: State:_
Zip Code: Fax:
Phone No.
E-Mail: IQ
kNS�
t cg
fiuowl<t . (Apm-
Fill in fee simple Title Holder page ( if different
from the Owner listed above)
E-Mail:
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
V
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x NotApplicable /
Name: cuhad B Peterson Architects �FafentP ftmati 1
MORTGAGE COMPANY: Not Applicable
Name:
Address: ,925 Prospect Ave
Address:
City: Orlando State: FL
ZiVa Phone: ao
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY: x Not Applicable
Name:
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
for as
STATE OF FLORIDA
COUNTY OF kFfl\54�tnlooglt
The forgoing instrument was acknowledged before me
this IS day of C ^ 20 4 by
br&�A_ Dmoq\ckS
(Name of person acknowledging ) WvOam of Q�n91tiNw'e_
(Sign atu of Notary trWc-State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
ASHLEY H.
S
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF_
The forgoing instrument was acknowledged before me
this _ day of 20 _ by
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
t'6NtMTgion No. (Seal)
EXPIRES May 13, 2018
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
RE IE
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DATE
�J
COMPLETE
/
INITIALS