HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (y�
Date SCANKfiGlit Number: O� ^V I��
�C IC) I? CQSe BY -is
Sf. L rri
Cle County ;� wyedaO+6u lkw ad
Building Permit Application 019� rinr
Planning and Development Services p3�303y
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: Alteration
FROPOSE,D IfViFROVE)VIENT LOCATION.:
Address: 5000 FEEDER RD., FORT PIERCE, FL
Legal Description: LAKEWOOD PARK -UNIT 12-A- BLK 178 LOTS 1 AND 2 (MAP 13/13N) (OR 4031-1626; 4081-536)
Property Tax ID #: 1301-615-0197-000-2
Site Plan Name: MOBIL 823
Project Name: MOBIL 823
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
INSTALL CARWASH ENTRY SINGLE CLEARANCE BAR AND PROTECTIVE BOLLARDS
OHVAC OGas Tank
11 Electric O Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 4,350.00
na— cnecKau
apply:
Piping
_Shutters
Windows/Doors
nklers
Generator
1:1Roof
=
Roof pitch
S Ft. of First Floor: _
Utilities: Sewer Septic
Building Height:
OV1(IVER/LESSEE: 5°.° 3: .,
`GO,NI`RAGTOR.`.,�°_` • a
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
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
a vame of construction is $zbuu or more, a Rtc08oED Notice of commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN
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 that
or and covenants 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 inte to obtain financing, consult with lender or an attorney before
commencingwork o cordin ur Notice of Commencement.STATE
OF
Rev. 8/2/17
LAW INFORMATION:
DESIGNER/ENGINEER:
Name: sunshine Real estate Ham��es uca
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Ad d ress: s000 Fascist Rd. Fort P�a�. Fmnaa
Address:
City: Dotal
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Signa a of w ee/Contractor as Agent for Owner
Signature of Contractor/License Holder
COUNTY OFOR��f},UI D/YD�'�
ORIDA��O���D
COUNTY OF
The f r�jng instr nt mils acknowledged before me
The fo��g instrumer�was acknowledged fore me
UA/E
this ay of a 20� by
thisd_ day of 20 y
- O1m= at/oat
iG1. N�fGC
Name of pets making statement
Name of persyn making statement
Personally Known OR Produced Identification
Personally Known V OR Produced Identification
Type r f Identification
Type of Identification
Prod ced C\OS
Produced
t
V�E��ptSB \Dp,
�.
V s OT OR
(Si nature of NotaryPublic- ' �.�t'i .,fsba 19
(Signature of
Nota Public- b��tate of Florida
�" 31a6l�
Commission No. � e'
Commission
G0�F���
�`��OADPIRES:embar42021
.E
t-"'Z*-j;
BanOedTMuNolaiyPu61(cUMemlter9
REVIEWS
FRONT
ZONING
SUPERVISO
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
EVIEW
REVIE
REVIEW
REVIEW
REVIEW
REVIEW
DATE
rj
RECEIVED
DATE
(�
J
COMPLETED
r2 CJ