HomeMy WebLinkAboutPermit app - Electrical RemovalAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
0 R�
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 Power removal
PROPOSED IMPROVEMENT LOCATION:
Address: 3980 US 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:
Disconnection of the power to the billboard to facilitate removal of the 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
Lot No.
Block No.
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
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 Co LLC
City: Pompano Beach State: _
Zip Code: 33064 Fax:
Phone No. 786-646-9107
Address: 7935 NW 60th Street
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-Mail Jose@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: XX 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 S US Highway 1
Address:
City: FT Pierce34982
City;
Zip: Phone:
Zip: 34982 Phone:772-488-3441
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 pos con the jobsite before the first inspection. If you intfnd to obtain financing, consult
with lender or an att,6rnqy before Spflimencing work or recording our Noti a of Co.' mencement.
Signature of Own / Lesse ntrac or as Agent for Owner
Signature of Contract/ ' ense Holder
STATE OF FLORTUAIN
STATE OF FLORIDA
,
COUNTY OF NOWA(A
COUNTY OF /Ol aml DVide
Swgt n to (or affirmed) and subscribed before me of
1(
Swor to (or affirmed) and subscribed before me of
Ph sical Prese ce or Online Notarization
5vAf
Physical Presence or Online Notarization
this day of 2020 by
this 11 day of TOO2020 by
J-0 S e (Y1 i ec�S
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of I 'on
Type of Identific t- n
Produ d
Produced
oNot
%00of
i n c Florida)
ublic State of Fbrida
mist Rulz
'� .votary Public - State of F
(Signature o No blic- StatE-n
Hoffmann(yZ�{off Seal ( )
Commission GG 959
Commission No. Cat qS°1d l�omm. Expires Aug 21
3Lourd
2
0,r.0 Expires 11/05/2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
a
0