HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
SCANNED Permit Number: AS
BY
St. Lurie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578
Commercial X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line NewBuilq!a
PROPOSED IMPROVEMENT LOCATION:
Address: 450OWestMidwa
Legal
Rd. Ft.
) OF 6�640
CIL MIDWAY RD) AND LESS
FL 34981.
11 AND 12 IN NE 1/4�LESS STRIP OF LAND LYG N OF AND ADJ TO S LI LOTS 9 TO 12 INCL BEING 62.4 FT ON W END
THRU 1109 (RD RAN FAVORITE RD AND MIDWAY RD)- (23.56 AC) (OR �5�214.
Property Tax I D #: 3406-501-0020-000-9 Lot No.
Site Plan Name: New Horizon's of the Treasure Coast, loc. Storage Facility Block No.
Project Name: Records / Storage Buflding
Setbacks Front Back: _ Right Side: Left Side
DESCRIPTIOWOF'WORK,
The Addition of 10,725sf. records/storage building
I CONSTRUCTION INFORMATION: I
KI HVAC
ElElectric
L=1 Gas Tank
[R] Plumbing
Piping 11 S'hut'ters a Windows/Doors
riders 1:1 Generator El Roof
Total Sq. Ft of Construction: —10,725 X 17 6 - 10
Cost of Construction:$
S Ft of First Floor:
Utilities,cn Sewer D —
Septic
Building Height:
Roof pitch
OWNER/LESSEE-
CONTRACTOR:
Name—New Horizon's of the Treasure Coast, In
--- Nf-
Name- 'cTael Jacquin
Address:-4500 W. Midway Rd.
Company: Paul Jacquin& Sons, Inc.
—
City: Fort Pierce State: FL.
Zip Code: 34981 Fax:
Phone No. 772-380-3424
Address: 7348 Commercial Circle
City: Fort Pierce State: FL
Zip Code:_ 34951 Fax: 772-466-2806
Phone No. 772-465-2475
E-Mail:— lwakefield(cbnhtcinc.om
Fill in fee simple Title Holderon nextpage (if different
from the Owner listed above)
E-Mail:
—scott.kraum@_pjsi.com
State or County License: QQQ 060473
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
11—
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: _ Phone:
BONDING COMPANY: —NotApplicable
Name:
Address:
City: ity:
Zip: Phone:
Zip: Phone: I
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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conxict 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 qe recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consul der or an attorney before
commencing work or recording vour Notice of Commencement. M411
Agent for Owner
STATE OF FLORIDA
COUNTY OF S-17. Luc�LF_
The forgoing instrument was acknowledged before me
this C, day of 20_11� by
J
Name of pers n making statement
Personally Known i�� OR Produced Identification
Type of Identification
Produced
STATE OF FLORIDA
COUNTY OF -ST- 1.14 f Ir—
The forIging instrument was acknowledged before me
this, ayof bEQP�113&q� 20 by
I&M61- zn��Qvl %I
Name of pe��aking statement
Personally Known OR Produced Identification
Type of Identification
LU Notary Public State of Flodda
rr%nq? R Wraurn
22t �Q`-,,
(51gri1iture of Notary PublFc- S MR" e offotary lu%4T't F 232514 S
or,
OMMIS I0N#GG07 ,,dF ExpireS05/11i 19
Commission No.1660-75-� (SegPIRES April 10, 20, 1 C mission No. e
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
� COUNTER REVIEW\ � REVIE1 REVIEW � REVIEW REVIEW REVIEW
I COMPLETED
Rev. 8/2/17