HomeMy WebLinkAboutPermit app - Structure RemovalAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
11r.
O w
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial x Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: BILLBOARD REMOVAL
PROPOSED IMPROVEMENT LOCATION:
Address: 3980 S. US HIGHWAY 1 St. Lucie County, FL
Property Tax ID #: 2434-501-0001-000-4
Site Plan Name:
Project Name: OUTFRONT MEDIA BILLBOARD REMOVAL
DETAILED DESCRIPTION OF WORK:
Removal of Billboard Structure.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping — Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
Generator
Sq. Ft. of First Floor:
Lot No.
Block No.
_ Windows/Doors _ Pond
Roof Pitch
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Lessee- Outfront Media
Name: Jose Miedes
Address: 2640 NW 17th Lane
Company: Arango Billboard & Construction Cc LLC
Address: 7935 NW 60th Street
City: Pompano Beach State: _
Zip Code: 33064 Fax:
Phone No. 786-646-9107
City: Miami State: FL
Zip Code: 33166 Fax: 786-483-8735
Phone No 786-615-7575
E-Mail: matt.okelI@outfrontmedia.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailjose@arangobillboard.com
State or County License CGC 1524177
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC 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:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: x Not Applicable
_
Name: Ronald Lyman
Name:
Address: 3980 US HIGHWAY 1
Address:
City: Ft Pierce
City:
Zip: 34982 Phone:772-466-3441
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and postederp the jobsite before the first inspection. If you irl end tq obtain financing, consult
with lender or an attor before commencing work or recording our Notice% f i ommencement.
Signature of Owner Lesse n ractor as Agent for Owner
Signature of Contractor icense Holder
STATE OF FLORI A
COUNTY OF row6✓d
STATE OF FLORIDA
COUNTY OF Miami .-Dad c-
Swor�to (or affirmed) and subscribed before me of
Swo to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
��// Physical Presence or Online Notarization
this � day of �„hc 12020 by
this 2-c) day of cJ00 9- , 2020 by
,Jose WedeS
Name of person making statement,
Name of person making statement.
Personal) Known V OR Produced Identification
Personally Known - i� OR Produced Identification
Typ Identi ation
Type of Identification
P duced
Produced
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Notary Public State of Florida
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Expires 11/05/2022
(Signature of . otary lic- State €, � `.) Commisysn i GG 959
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Commission No.
REVIEWS
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
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REVIEW
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REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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