HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED hh
Date: Permit Number: V_ " n `
.r�.•--�4 T ��.��=, ,_ _� RECEIVED
Building Permit Application FEB 3 718
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fart Pierce FL 34982 st. Lucie Countv
Phone:(772)462-2553 Fax:(772)462-2578 Commercial x Residential
PERMIT APPLICATION FOR;
PROPOSED INPROVEMENT LOCATION:
Address: 8733 S Federal Hwy#sign
Legal Description: 3414-501-1916-350-7 billboard structure
Property Tax ID##: 3414-501-1916-350-7 Lot No.
Site Plan Name: Block No.
Project Name: Put meter back in existing billboard structure
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
Reinstall damaged meter on existing billboard structure per FPL
CONSTRUCTION INFORMATION:
Additional work to be pertormed under this permit–check all that appy:
_Mechanical —Gas Tank _ Gas Piping —Shutters _Windows/Doors
x Electric _Plumbing _ Sprinklers _Generator —Roof Pitch
Total Sq.Ft of Construction: 0 Sq. Ft.of First Floor: 0
Cost of Construction:$ 250 Utilities: —Sewer _Septic Building Height:
01NNER/LESSEE CONTUACTORs
, N .h ll =�
Name Lamar Outdoor Lakeland Name; Michael Zomek
Address: 3760 New Tampa Hwy Company: Untra Lum Enterprises, INC.
City: Lakeland State:FL Address: PO Dox 2188
Zip Code: 338145 Fax: 863-682-5498 City: Palm Harbor State: FL
Phone No. 863-808-9353 , Zip Code: 34682 Fax:
E-Mail: rbehrle@lamar.com phone No 856-207-5946
Fill in fee simple Title Holder on next page(if different E-Mail untraluminc@gmail.com
from the Owner listed above) State or County License ec13004138
if value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: x Not Applicable
Name: Lamar Outdoor Lakeland Name:
Address: 3760 New Tampa Hwy Address:
City: Lakeland City:
Zip: 33815 Phone: 407-808-9353 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 o attorney before
commencing work or recording our Notice of Commencement.
-5-ex
Signature of Owner/Lessee/Contractor as Agent for Owner Signat=FFLORI
tractor/License Holder
STATE OF FLORIDA STATDA
COUNTY OF Polk COUNTY OF
The forgoing instrument was acknowledged before me The for oing instrumen was acknowledged before me
this +3 day of Fer .20 s by this day of V6& 20 by
Name of person making statement. Name of person making stateme t.
Personally Known X OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
4 -40/�r
(Signature of Notary Public-State of Florida) (Signature of Notary Public-Stat rida)
1 eft
ENRLE
Commission No. (Seal) Commission No. :�.•,�'�°:B; j MYC pN#GG
FION ii GG 028074`
zu;.
V. EXPIRES:September 12,2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIO LE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
SUPPLEMENTAL CONSTRUCTION.LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: X Not Applicable
Name: Lamar Outdoor Lakeland Name:
Address: 3760 New Tampa Hwy Address:
City: Lakeland City:
Zip: 33815 Phone: 407-808-9353 Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 WNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvemen s 'o your property.A Notice of Commencement must be recorded and posted on the jobsite
before th fi t Inspection. If you intend to obtain financing, consult with lender or an attorney before
commen n rk or recording our Notice of Commencement.
Signature f 0 ner/Lessee Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Polk COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 13 day of February ,20 18 by this day of ,20_ by
Name of person making statement. Name of person making statement.
Personally Known X OR Produced Identification Personally Known OR Produced Identification
Type of Identific tiort Type of Identification
Produced ? . :— Produced
:. M' :OMMI:al ^ :5:1.0074
Ods EXPIRES: .r Cyr 020
..3ordad ThruN:(Signature of N - rY • (Signature of Notary Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
8/2/17 ;w�,� RICHARD BEHRLE
+= MY COMMISSION#GG 029074
EXPIRES:September 12,2020