HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -�3\ -t 15 Permit Number: ASO d1'4 3a
;. f RECEIVED SEP 0 8 2015
Building Permit Application
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 Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line q
PROPOSEDINIPRO.VEM'ENT1OCATI6N:
Address: 1020 SHOREWINDS DR., FT. PIERCE, FL 33449
Legal Description: CORAL COVE BEACH-SECTION ONE-BLK 7 LOT 10 AND THAT PORTION OF VAC ALLEY ADJ NW
COR(OR 260-902)
Property Tax ID#: 1425-701-0175-000-7 Lot No. 10
Site Plan Name: Block No. 7
Project Name:
Setbacks Front Back: Right Side: Left Side:
0LTAILED4 DESCRIPTION',OFWORK:
REPLACING ONE OF TWO A/C.UNITS. -7 Y2 Tb� 1�� �b� P �
Nd 14t0 � r 13 ettZ
CONSTRUCTIQN IN,FORMATION
Additionalwork to be nertormed under t ispermit—check all rJ appy:
❑✓ '
HVAC Gas Tank F_] Pin Gas Pi _ Doors
Piping Shutters ❑Windows/
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ 11,364.00 Utilities:i Sewer O Septic Building Height:
O,'W; ER/
LESSEE CONTRACTOR:
Name CUMBERLAND FARMS INC. Name. ANTONIO RIVERO
Address:100 CROSSING BLVD Company: T.R.A.C. REFRIGERATION, INC.
City: FRAMINGHAM State:MA Address: 2800 SW 3RD TERRACE
Zip Code: 01702 Fax: City: OKEECHOBEE State.FL
Phone No. Zip Code: 34974 Fax: 863-763-8879
E-Mail: Phone No. 863-763-8809
Fill in fee simple Title Holder on next page(if different E-Mail: tracokeechobee@yahoo.com
from the Owner listed above) State or County License: CAC055501
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
i pp MORTGAGE COMPANY: ry
DESIGNER ENGINEER: _Not Applicable Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone:_ Zip: Phone:
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 thepermit 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
commencing work or recording our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA /�
COUNTY OF_ `� . LOc �� COUNTY OF Lkeechdbee
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of Se p-� 20 15 by this 8 day of 5[p�tm�rx 20 /5 by
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`Qt h OIY� O y d f-tn�o h►D verd
(Name of person acknowledging) (Name of person acknowledging)
was.
(Signature of Notary„P ic-State of Florida) (Signature of Notary Public- to of Florida)
Personally Known • 1A1,9Ri:V Ns rsonally Known V OR Produced Identification
Type of Identification Pr u �'�� t- L state of Florid pe of Identification Produced
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M omm.Expires Dec 16,20 6
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Commission No. lg �nission#EE 858761 mmission No. EE G O r•. .:(S�eeaal,
o; :; W80MMISSION#EE 90
°'� Bonded Through National Notary As n,
••,, EXPIRES October 29, 6
N 8en�o•.Com
Revised 07/15/2014
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