HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
F L D R l D A
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1SS3 Fax: (772) 462-1S78
Permit Number:
Building Permit Application
Commercial Residentia
PERMIT TYPE: COMMERCIAL INTERIOR REMODEL
PROPOSED IMPROVEMENT LOCATION:
Address: 4878 N. KINGS HWY, FORT PIERCE, FL 34951
Property Tax ID #: 1313-232-0001-010-7
Site Plan Name:
Project Name: MCDONALDS KINGS INDRIO
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
LIMITED INTERIOR REMODEL TO DINING ROOM AND ORDER ENTRY AREA. GENERAL DECOR UPDATES.
NO KITCHEN WORK PROPOSED. NO EXTERIOR WORK PROPOSED.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
x Electric x Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 75000
Sq. Ft. of First Floor:
Utilities: x Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name MCDONALDS CORPORATION
Name: JOHN STEGE
Address: 110 N. CARPENTER STREET
Company: STANSELL PROPERTIES & DEVELOPMENT
City: CHICAGO State: FL
Zip Code: 60607 Fax:
Phone No. 772-473-8285
Address: 11607 Prospect Road
City: Odessa State: FL
Zip Code: 33556 Fax:
Phone No 727-372-0781
E-Mail: LIZ.HAMILTON@KIMLEY-HORN.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail LORI@STANSELLCONSTR.COM
—
State or County License CBC1260211
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 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: SCOTT PURDY I PURDY & M UROFF ARCHITFCTURF
Name:
Address: 1711 N. HIMES STREET
Address:
City: TAMPA State: FL
City: State:
Zip: 33607 Phone 813-353-0635
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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
FROSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of , 20_ by
Name of person malting statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
1A. %A�
Signatur of Contractor/Lit nse Holder
STATE OF FLORIDA pa-'sco
COUNTY OF
The for Ding instru ent wa acknowledged before me
this day of 200 by
a-�• � ,e Q e.
Name of person making statement
Personally Known
Type of Identification ,
Produced 1
ceAr i ihr ao d , _
Lori Suarez
F My Commimion GG 242227
r res 07/27J2=2
of Niitary Py6lio-_Nte of Florida )
Commission No. ` _I (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/ 19
DocuSign Envelope ID: DDA264C3-F78C-4320-8438-DAB28247258E
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name: SCOTT PURDY I PURDY & MUROFFARCHITECTURE
Name:
Ad d ress: 1711 N. HIMES STREET
Address:
City: TAMPA State. FL
City: State:
Zip: 33607 _ Phone 813-353-0035 _
Zip: Phone: _
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: XNot 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
DocuSigned by;
64nagwepf Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF _
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The for ing instrum t was acknowledged before me The forgoing instrument was acknowledged before me
this day of , 2CD by this day of , 20M by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced _
ignaWe of No
Commission No.
01 w 0 022
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No. _ (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. L///19