HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST :OMPLETED'FOR APPLICATION TO BE ACI' ED
Date: Permit Number: MCI--
SCANNED
— BY
St. Lucie County RECENED
Building Permit Application
MAY 09' Z018
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 st. Lucie County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Yes Residential
PERMIT APPLICATION FOR: Other
PROPOSED,IMPROVEMENT LOCATION: ,
Address: _ 1020 Shorewinds Dr, Ft pierce, FL 34949
Legal Description: See survey
Property Tax ID #: 1425-701-0175-000-7 Lot No. 10
Site Plan Name: Block No. 7
Project Name: Cumberland Farms Shorewinds Canopy Replacement
Setbacks Front Back: Right Side: Left Side:
DETAIL'ED;DESCRIPTION,OF'WORK:
Construction consists of a new canopy to replace the existing damaged canopy and
restriping to provide 3 additional parking spaces on site. No offsite improvements are
proposed.
CONSTRUCTION; INFORMATION:
itiona war to a ertormed under this permit -check all apply:
❑HVAC Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
Electric Plumbing Sprinklers Generator 11 Roof Roof pitch
Total Sq. Ft of Construction � O 5/ S Ft. of First Floor: N/A
Cost of Construction: 0(I'OG7yutilities:�5ewerDSeptic Building Height: N/A
,OWNER/LESSEE: . `V
CONTRACTOR:
Name- Vsh Realty Inc, Cumberland Farms Inc
Name:wila
Address: 100 Grossing Blvd
Company: SX1tLlS�Y IES�Ti�r
City: Framingham State: MA
Address: 151'SUC) WCM" iIL_L-IAC
City:�Cj%� ir%�fCP State: LL
Zip Code: 01702 Fax:
Phone No. �( - oZ1O' �t I�1
Zip Code: ?)4ge6L4 Fax: -1-19-%51I
E-Mail:
Phone No. —IT OL - "L oQ-J6�)I0
Fill in fee simple Title Holder on next page ( if different
E-Mail:e[(rf{5S`tlryd °CI�4)11 Yll�l
from the Owner listed above)
r
State or County License: CPP_La,51L_qb1
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
S'UPFL_ ENTALCO STRU@TIONjL1E1V
LAW INFORMATIO
I t; l � 4 s ryl
DESIGNER ENGINEER:
Name:
_Not Applicable
MORTGAGE COMPANY:
Name:
Name:
Address:
_Not Applicable
Address:
City:
Zip:3agtsa Phone-:-ta--A
t-
State: Fl—
to --raga
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
Zip: Phone:
City:
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.
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. Lurie 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
COUNTY OF.
The forgoing Instrument was acknowledged before me
this gL day of 20JE: by
_(imIrA S, Iwrma o
Name of persop making statement
Personally Known ,.,(OR Produced Ide ;on
Type of Identification 0..
(Signature of Notary
Commission No.
STATE OF FLORIDAI1 I , , C I
COUNTY OF— lL
The f g instru t as cknowledg fore me
thi ay of 20 by
I nV lyrlr4
Name of pkrsgA making statement
Personally Known XOR Produced Identification
Tvoe of Identification
(Signature of Notary Public.StateK NotaryPublic-Stat
I /_7�5 . Commission = uG
Commission No.hh 7 1jty Comm. Exores D
� •.'. `.,. GoMetl0rcagh Na-oca
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2021