HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: '�' I 1 I J 4 SCANNED Permit Number:4�01
MYriJL._.,� - St. Lucie County ERECEIVEID
Building Permit Applicatio12018
Planning and Development ServicesBuilding and Code Regulation Division ty, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Alteration II
LPROPOSED IMPROVEMENT LOCATION:',;
Address: 5000 FEEDER RD., FORT PIERCE, FL
Legal Description: LAKEWOOD PARK -UNIT 12-A- ELK 178 LOTS 1 AND 2 (MAP 13/13N) (OR 4031-1626; 4081-536)
PropertyTax ID #: 1301-615-0197-000-2
Site Plan Name: MOBIL 823
Project Name: MOBIL 823.
Setbacks Front Back: Right Side: Left Side:
INSTALL CASH BOX FOR CARWASH AS PER VIOLATION CASE 93843
Lot No.
Block No.
�VUIUUI idi vvvin w IJ ,w, II ICU ui wci uu�No uuL —uietn du dNNiy:
HVAC Gas Tank E]GasPiping _Shutters Windows/Doors
_ Electric Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: ScFt. of First Floor:
Cost of Construction: $ 2,350.00 Utilities:Sewer OSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR: <.,
Name SUNSHINE REAL ESTATE HOLDINGS LLLP
Name: STEVEN M. NALE
Address: 1650 NW 87TH AVE
Company: GREAT DANE PETROLEUM CONTRACTORS
City: DORAL State: FL
Zip Code: 33172 Fax:
Phone No. 305-477-5800
Address: 1330 S. ANDREWS AVE
City: POMPANO BEACH State: FL
Zip Code: 33069 Fax:
Phone No. 954-214-4087 1
E-Mail: mzamora@sunshinegasoline.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: mario@greatdanepetroleum.com
State or County License: CBC045595
IT value or construction Is Sz5uu or more, a RECURDED Notice of Commencement is required.
tir
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: Sunshine Real Estate Holdings LLLP
MORTGAGE COMPANY: _ Not Applicable
Name: PS S ELECTRIC
Address: 5000 Feeder Rd. FoA Pierde, Flonde
Address: 165D NW 6TTH AVENUE
City: coral State:
Zip: Phone
City: MIAMI State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:12691 SW 2ND STREET
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 authorize the permit holder to build the subject structure
which is in contlict 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 int btain financing, consult with lender or an attorney before
commencing work or rezidin ur Notice of Commencement.
w
Signature of g ner
ctor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORI
COUNTY OF
i �/!I VC
STATE OF FLORIDA
COUNTY OF
The for 'ng instr ent
as acknowledge before me
The forgoing instrum�pt,�y &nowledged ¢efore me
V E
this ayof,�a�
20 by
this day of 20/gby
D
Al VAy1a,
STE!/E/� A4,
Name of pers
making statement
Name of persgn making statement
Personally Known
OR Produced Identification
Personally Known V OR Produced Identification
Type of I ntification
Type of Identification
Produce
Produced
C10S
/J
(SignaVuretf Notary Publi �jo F,4213
(Signature of Notary Public- State of Florida )
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Commission No.
3I2612.0'9
Commission N .••:�+:+. MARI0AG(8ffid)
.2 UYCOMMWIONDW153722
;:,� EXPIRES: Nmm.ber4, 2021
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FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
MANGROVE
SEA TURTLE
COUNTER
REVIEW
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REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17