HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/09/2017 MW100 along l5 SCmber:
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" - a3NNdOS BY
St. Lucie County
- -
Building Permit Application RECEIVED
Planning and Development Services AUG Z Z Z017
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 -
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial W— Residential
PERMIT APPLICATION FOR: Other III
I: PROPOSED IMPROVEMENT LOCATION;; III
Address: 887 NE Prima Vista Blvd.
Legal Description: RIVER PARK -UNIT 3-E388.35 FT OFTRACT D AS MEASURED ALG THE NLI OFSDTRACT(MAP 34122S)(OR 2622-1580 THRU 1592)
Property Tax ID #: 3419-515-0001-000-3 - Lot No.
Site Plan Name: Poit St. Lucie Shopping Center Block No.
Project Name: Port St. Lucie Shopping Center
Setbacks Front25 Back: 20 Right Side: 10 LeftSide: 10
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Construction of a wastewater grinder station to be built, specified, permitted through, and turned over
to the'Port St. Lucie Utility Systems Department (PSLUSD). The station will include a force main
connection to the existing PSLUSD force main located in the Prima Vista right of way.
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CONSTRUqtIONINFORMATI®Nry h" "
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Acid Itlona I wo rK to be nerrorme - und ert isperm it—c ec a I I apply:
OHVAi Gas Tank ❑Gas Pipidg _ Shutters Q Windows/Doors
DElectric Z Plumbing Sprinklers 1:1 Generator El Roof F Roof pitch
Total Sq. Ft of Construction: N/A S . Ft. of First Floor: N/A
Cost of Construction: $ 100,000.00 Utilities:Lid Sewer Li Septic Building Height: NIA
OWNER/LESSEE.::
_
EONITACTOR�n.�a.s r•-
Name Michael Calanddlio
Name: Rantly Bowe s
Address.469'Mariner Drive
Company: R.K. Contractors, Inc.
City: Jupiter - State: FL
Zip Code: 33477 Fax: (561) 747-3662
Phone -No: (772)-8785947 . -- -
Address: 2860 Brocksmith Road
City: Fort Pierce State: FL
Zip Code: 34945 • - Fax:' (772) 462-0765 —
Phone No. (772) 462-0770
E-Mail:,Calmike0D9@aol.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: rkcontractorsinc@bellsouth.net
State or County License.
If value of construction. is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.
to
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DESIGNER/ENGINEER: _Not
Name: Jaymn R.Hamsun
gpplicaste
er,
MORTGAGE COMPANY.
Name:
b✓J Not Applicable
Address: 10250 swyiOage Parkway. suite 201
.. �. -1.„� ( 0�,
Address:'
City: Port StLuda
Zip: 349a7 Phone772A62-us5
State: FC
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: ✓
Name:
Not Applicable
BONDING COMPANY:
Name:
✓ Not Applicable
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
which is
:e the permit holder to build the subject structure
or and covenants that may restrict or prohibit such
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
commencinl=_.work or recording vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contra or/License Holder
STATE OF FLORI��4� y _
STATE OF FLORIDA
COUNTY OF
COUNTY OF c;4-. Luc Ie
The fo �y� g.instrumen was ac owledge efore me
The forgoing instrument was acknowledged before me
this,��dayof 20�cby
this l0Mday of�„< 201_t by
/
I'lik-lo � A714nc�r. t 1c,
F3owcr5
Name of person aking statement
Name f persommaking statement
Personally Known OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Sig�ure of ry
(Signature of Notary Pub is-5 a offlo ida )
DTpNCY_L,STAMMCommission
No.nmco, a
NPAR
Commission No. ANNE-M�li$UDLUMID@>RI,SNDeot714
MY COMMISSION M FF0640QS '4? EXPIRES: Jemmy 27, 2016
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17