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HomeMy WebLinkAboutBuilding Permit Application r ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: (� Permit Number: I I © I L9 Building Permit Application DEC 0 5 2017 Planning and Development Services PER,"/i I17I NG Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential PERMIT APPLICATION FOR: Building Z&vto PROPOSED IMPROVEMENT LOCATION: Address: 6598 S US HWY 1 PortSt Lucie,FL 34952 Legal Description. See additional sheet Property Tax ID#: 3415-502-0011-000-4; 3415-502-0014-000-5; 3415-502-0015-000-2 Lot No. Site Plan Name: Block No. Project Name: Burger King#29752 Setbacks Front Back: Right Side: Left Side: i DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: Additional work to b rtormed under this permit-check a appy: ❑HVAC Gas Tank E]Gas Piping _Shutters Windows/Doors 11 U Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ 010 Utilities:Z Sewer Septic Building Height: _ OWNER/LESSEE: CONTRACTOR: Name Seven Real Estate Holdings,LLC/Leo Leon Name: S Address: 117 Hidden Glen Way Company: City: Dothan State:AL Address: &L jL sk&u !/O Ar Zip Code: 36306 Fax: City: ()y �.p /'J/-) _ State:—& Phone No.954-909-8141 Zip Code:_33-7)to S Fax: DC7-7.�CoIP �3 E-Mail:Leo.leon@goldcollc.com Phone No. 07- J' Co& ` I S&`l Fill in fee simple Title Holder on next page (if different E-Mail: ' a 5 ; from the Owner listed above) State or County Lic nse: `1 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: RobertWulbern Name: Address: 6034 Chester Ave Address: City: Jacksonville State: FL City: State: Zip: 32217 Phone 904-329-2510 Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: 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 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 insp n. If you intend to obtain financing, consult with lender or an attorney before commencing woi­ ecordi2aur Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF ( �Lo�; STATE OF FLORIDA COUNTY OF `� I]L�" COUNTY OF Ii nn"'Izl�^ The fo�r oing instrume-Qnt lwIa�s acknowledged before me The for ing instru rix was ac nowledged before me this olq day of�202 y� ► 20rL by this�—day,of/ ILA- 204 by �� I ,ons � h S ( c t 's. Name of person making statemeWtiIIIfill Name of person making statem t Personally Known OR Produ, Personally Known OR Produced Identification Type of Identification �� \ hr .� Type of Identification Produced ()��eP�SStoNF10 Produced Ut s �•G / (Signature of Notary Pub c-State�f 2,t.. kr` (Signature Notary ic-State to d ) —`� APPY pua IL�. RZ Commission No. �i� �JS1 �� Commission No. *� • ". °* MMISSION,9$d EXPIRES:Aug srq P°` Bonded ThruBudget NotaryseNke REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17