HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/23/19 Permit Number:
SCANNED
BY
St. Lucie Coup
Building Permi6pplication
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x
RECEIVED
JAN 3 0 2019
Permitting Department
et, wale county
Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT -LOCATION:
Address: 301 PRIMA VISTA Blvd
Legal Description: RIVER PARK -UNIT 4 BLK 39 LOTS 33,34 AND 35 (MAP 34/28N) (OR 3722-2672)
Property Tax ID #: 3419-530-0219-000-1
Site Plan Name:
Project Name: CVS Pharmacy #4254 Stockroom Design
Setbacks Front - Back: Right Side: LeftSide:
Lot No.33-35
Block No. 39
CWAILED DESCRIPTION OF WORK: IIII
INSTALL NEW STAIRS WITH HANDRAIL AND GUARDRAIL. reinforcing existing mezzanine floor -
no trade work involved
CONSTRUCTION INFORMATION:
itiona wor to e e rme un ert ispermit—check
11HVAC []Gas Piping
all apply:
in
[]Windows/Doors
GasTank
_Shutters
Electric El Plumbing
Sprinklers
0 Generator
Roof Roof pitch
Total q. Ft of Construction: 280
SFt of First Floor:
as of Construction: $ 51,641.00
Utilities: Sewer 0Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name CVS Health
Name: Robin Lynn Dean
Address: 1 CVS Dr
Company: Awesome Construction Inc
City: Woonsocket State: RI
Zip Code: 62895 Fax:
Phone No.401-765-1500
Address: 3766 NW 124th Ave
City: Coral Springs State: FL
Zip Code: 33065 Fax: 866-201-7222
Phone No. 954-345-6776
E-Mail: Josh.Roth@cvshealth.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: robin@awesomeconstruction.com
State or County License: CGC1507113
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
J � �
SUPPLEMENTAL CONSTRUCTIONLIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:Ken Mackenzie
MORTGAGE COMPANY: F,7 Not Applicable
Name:
Address: 201 S. Maple Dr Ste 300
Address:
City: Ambler, State: PA
Zip: 19002 Phone21"09-2126
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: Moradebi LLC
BONDING COMPANY: allot Applicable
Name:
Address: 19370 Collins AVE Ste CUt
Address:
City: Sunny Isles Beach, FL
City:
Zip: 33160 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 conflict 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 intend to obtain financing, consult with lender or an attorney before
commerming work or recording vour Notice of Commencement. f
Sign ture of Owne essee/ ontrac r as Agent for Owner
Signature 6ontracto License Holder
STATE OF FLORID
STATE FLORIDA
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COUNTY OF C./
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COUNTY OF
The forgoing instrumen as acknowledged before me
The forgoing instrument was acknowledged before me
this day of20by
this 20/ by
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Name of peyorl making statement
Personally Known OR Produced Identification
Name of perso makings tatement
Personally Known __ X OR Produced Identification
Type of Identification
Type of Identificatio
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(S�ignatdre of a ary Public- State of Florida U
(Signature of Notbiry Public- State of Florida )
Commission No. 'k4 ANSCHERRY
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIE
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
1
DATE
COMPLETED
Rev.8/2/17