HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
SM [L UIC M
L' ' LlBuilding 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: ST LUCIE SIGNS REMOVAL OF PLANET FITNESS SIGNS
PROPOSED IMPROVEMENT LOCATION:
Address: 6666 S US HIGHWAY 1
Property Tax ID#: 3415-501-0065-000-4 Lot No.7 &8
Site Plan Name: PLANET FITNESS Block No. 4
Project Name: PLANET FITNESS REMOVAL OF WALL SIGN
DETAILED DESCRIPTION OF WORK:
REMOVE EXISTING PLANET FITNESS SIGNS, CAP ELECTRIC.
New Electrical Meter NA Second Electrical MeterNA
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical —Gas Tank —Gas Piping —Shutters —Windows/Doors _Pond
_Electric —Plumbing —Sprinklers —Generator —Roof Pitch
Total Sq. Ft of Construction: 93280 Sq. Ft. of First Floor: 93280
1700 Utilities:
Cost of Construction: $ —Sewer —Septic Building Height: 1 STORY
OWNER/LESSEE: CONTRACTOR:
Name PLANET FITNESS Name:JAMES M NOLE
6666 S US HIGHWAY 1 Com an :ST LUCIE SIGNS LLC
City: PORT SAINT LUCIE State:— Address:1147 HERNANDO ST
Zip Code: 34952 Fax: City: FORT PIERCE State:FL
Phone No.714-520-3324 Zip Code: 34949 Fax: NA
E-Mail:GINO.CASTRILLON@COASTSIGN.COM Phone No 772-971-6363
Fill in fee simple Title Holder on next page(if different E-MailSALES.STLUCIE@GMAIL.COM
from the Owner listed above) State or County LicenseES12001557
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: 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
xr./'t.-e
Signature of Owner/Lessee/Contractor as Agent for Owner SignatL4,f of Contractor/License Hofder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINTLUCE COUNTY OF SAINTLUCIE
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
x Physical Presence or Online Notarization x Physical Presence or Online Notarization
this 20 day of AUGUST 2020 by this 20 day of AUGUST 12020 by
JA,MES MICHAEL NOLE JAMES MICHAEL NOLE
Name of person making statement. Name of person making statement.
Personally Known x OR Produced identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced 1 , Produced
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