HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONl
SCANNED
BY
St. Lucie County
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED rJ
Date: 7 / :3/
. ) - ) / SCANNFEEmit Number:
BY
St. Lucie County
Building Permit Application AUG / 12017
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Port Pierce FL 349B2
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial C Residential
PERMIT APPLICATION FOR: Renovation
10570 S US HWY 1 Port Saint Lucie 34952
Legal Description: ST LUCIE GARDENS 12 37 40 BLK 1 S 1/2 LOTS 12 AND 13 LYG ELY OF US1-LESS N
20721 FT (AS MEAS ALG ELY RIW US 1) (1.88 AC) (MAP 44/12N) (OR 3222-423) Please see attached
Property Tax ID #: 3414-501 4713-300-0 Lot No.
Site Plan Name: Block No.
Project Name: Gold Coast CU
Setbacks Front Back: Right Side: Left Side:
Remove existing two (2) lanes of drive up equipment and swapping out with new drive up equipment.
imechanical work is needed for the vacuum assist tubing. Low voltage is disconnecting
current equipment and install new circuits.
0HVAC
MGas Tank
E�GasPiping
1:1Shutters
❑Windows/Doors
ZElectric
✓❑_Plumbing
Sprinklers
OGenerator
1:1Roof
=
Roof pitch
Total Sq. Ft of Construction:�
Cost of Construction: $ f o 0
S Ft. of First Floor._
Utilities: Sewer 01 Septic
Building Height:
6
Name 10570 Realty LLC
Name: Anton Rochek
Address: 10570 S US Highway 1 Ste 101
Company: The Platinum Group, Inc.
City: Port St Lucie State:FL
Zip Code: 34952 Fax: NA
Phone No. NA
'Address: 733 Commerce Dr Ste 3
City: Venice State: FL
Zip Code: 34292 Fax: 941488-5203
Phone No. 941-484-1213
E-Mail: NA
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: kdstina.rohl@thepla8numgroupinc.com
State or County License: EC0001672
If value of construction Is Moo or more, a RECORDED Notice of Commencement Is required.
to
DESIGNER/ENGINEER: X Not Applicable
Name:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
Address:
City: State: _
Zip: Phone:
City: State:_
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY: x Not Applicable
Name:
Address:
City:
Address:
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
commencing work or recording vour Notice of Commencement.
Signat e of Owner/Lessee/Contractor as Aant for Owner
Signatureof Cdntiacfor/LiicenstTiolde`F
STATE OF FL9R! �w yor
STATE OF FLORID I
COUNTYOF S
COUNTYOF �lacf��<JT�
The �ffwgoing instrument was acknowledged before me
this _Z-'� day �k aby
The forgoing instrument was acknowledged before me
this-2
� day Not 20 by
of. 20
of �,
%Jo0 Cz-�
O' e/) eI e b eJ's�
(Name of person acknowledging)
(Name of person
macknowledging)
(Signature of Notary blic- State of Florida )
�Signature�blic- State Of Herida-}.
NeW4or-1e y/
Personally Known OR Pr duced Identification _
Personally Known
Type of Identification Produced Let, L i Cie w Si
y
Type of Identification Pr ' "' k. /! EE-4-FE-6
Commission No. S
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Commission No. k MY c0 ION # FF831409
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06299108
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Expires Mar 17, 2018
Revised 07/15/
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