HomeMy WebLinkAboutExecuted Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Applicati®n
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT TYPE: Building addition
PROPOSED IMPROVEMENT LOCATION:
Address: 200 S. Kings Hwy
Property Tax ID #: 2312-313-0020-000-1
Site Plan Name:
Project Name: Love's 467 - Customer Laundry Addition
DETAILED DESCRIPTION OF WORK:
Adding Approximately 245 sq ft to existing building for Customer Laundry
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
x Mechanical _ Gas Tank _ Gas Piping _ Shutters
x Electric x Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction: 245
Cost of Construction: $
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic
Lot No.
Block No.
x Windows/Doors
Roof Pitch
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Love's Travel Stop & Country Store, Inc
Name: John Martin
Address: 10601 N. Pennsylvania Ave
Company: JC Curtis Construction
City: Oklahoma City State: OK
Zip Code: 73120 Fax:
Phone No. 405-463-8931
Address: PO BOX 5127
City: Chattanooga State: TN
Zip Code: 37406 Fax:
Phone No 423-894-5480
E -Mail: Construction_ Utilities_Permits@loves.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailjmartin@jccurtisconstruction.com
State or County License
I VO—C UI UVIIJLl 41.1.11.011 1Z .7GJVU Uf f11Ure, a mtl u uru rvotice of l.ommencement is requireci.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: Harrison French and Associates
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: t705s.Walton Blvds.iteB
Address:
City: Bentonville State: AR
Zip: 72712 Phone479-273-7780ext285
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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."
- Love's Travel Stops
_ C
Si Contractor/License
Sign6ure Owner/ Lessee/Contractor as Agent for Owner
ature of Holder
OKLAHOMA
STATE OF FLOR!!DA
STATE OF Rap
COUNTY OF OKLAHOMA
COUNTY OF��� h
The forgoing instrument was acknowledged before me
The forgoing instrume t was acknowledged before me
this 16TH day of Jluly 20 2o by
this day of J20ZD by
Crystal Vickers
aJO�n �lg ����1ltiilliiliJl7
Name of person making statement.
Name of person making statement.
Personally Known X_ OR Produced identification
Personally Known OR Produced Iden I ation
Type of Identification
Type of Identification =
Produced
TENNESSEt
Produced — NOTARY
pJ3
aa�
S
(Sign' ure of N 'ary Public- State of Q!UU+'(S'
(/ b� aCommission
n pure of Notary Public- State of da ) Ten t\
No. 1Rnn7149
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
VCV. G/ // 17
V
11W ves.
Travel Stops 10601 North Pennsylvania, Oklahoma City, OK 73120
Country Stores
800-388-0983 o www.loves.com
July 9, 2018
TO WHOM IT MAY CONCERN:
This letter is to authorize that the following list of current employees are legal authorized
representatives of Love's Travel Stops and Country Stores, Inc. These representatives have
authorization to execute any documents required in applying for and/or obtaining permits,
setting up utilities, speaking with vendor/company representatives, scheduling installations,
and the purchase of project related equipment and materials. This includes but not limited to
Design, Planning or Zoning Reviews and Hearings.
List:
Tom Squires, Vice President, Construction and Maintenance
Randy Swain, Project Manager Supervisor
David Webb, Sr. Project Manager
James McLemore, Project Manager
Eli Vanhooser, Project Manager
Ryan Killgore, Project Manager
Crystal Vickers, Project Coordinator Supervisor
Lance Schmidt, Facilities Maintenance Supervisor
Cindy Haikin, Facilities Administration Supervisor
If you have any further questions, please do not hesitate to contact me.
1 - U�- gle
Greg Love
Co -Chief Executive Officer
Love's Travel Stops and Country Stores, Inc.
GL/cah