HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:-QA%b1aa Permit Number: aada'day�
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RECEIVED
A'Permit Application
Planning and Development Services A - I FEB 10 2020
Building and Code Regulation Division \, 5 00G
2300 Virginia Avenue, Fort Pierce FL 34982 ST, Lucie County, Permitting
Phone: (772) 462-1553 Fax: (772) 462-1S78 Commercial X Resi d entla
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 4878 N. Kings Highway, Fort Pierce, FL 34954
Property Tax ID #: 1313-232-0001-010-7
Site Plan Name: McDonald's Kings Highway MRP
Project Name:
DETAILED DESCRIPTION OF WORK:
Side by side addition. I
SIB and i10A
• r•
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical
Electric
Gas Tank
_ Plumbing
Total Sq. Ft of Construction::`
Cost of Construction: $ 115, 000
_ Gas Piping
_ Sprinklers
_ Shutters
_ Generator
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic
Lot No.
Block No.
Windows/Doors
Roof Pitch
Building Height:
'OWNER/LESSEE:
,CONTRACTOR;
NameMcDonald's USA LLC
Name: 'So4.4n"c S14r l `-
Address:110 N. Carpenter Street 5-NE
Company:
City: Chicago State: IL
Zip Code: 60607 Fax:
Phone No.954-426-5144
Address: \k6 6-1 l os
City: Stater
Zip Code: 1-1SS4 Fax�a�3�a-03CL
Phone No -1 zL--\
E-Mail:dawn@corporatepropertyservices.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail i6c eQ s}q. se t+c or.a} (-ow\
State or County License C 6 o t� G o a 11 3 t S`I4
If value of construction is 52500 or more, a RECORDED Notice of Commencement is requirea.
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: cPH Inc. -Damn Bans
MORTGAGE COMPANY: _ Not Applicable
Name: NIA
Ad d ress: w1 Manner street. N1o6
Address:
City: Tampa State: FL
Zip: 33609 Phone 813-288-0233
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:wA
BONDING COMPANY: _Not Applicable
Name:N/A
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 Countty� 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."
2L ZZ--
AA A. 9.1-
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signatu a of Contract/License Holder
STATE OF PLOMA a a'
STATE OF FLORIDA
COUNTY OF co6-6
COUNTYOF PO_SCo
The forgoing instrument was acknowledge before me
The for oing instru a was acknowledged before me
thisa( clay of F-Q—B 20ZZ_OO by
thisdayof e 20o1_Oby
John T• Se42
Vivian Valdivia
Name of person making statement.
Name of person making stateritAnt.
Personally Known ✓ OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
d • �-�""
Notary Public Stets of Floft
Ignat
(S' ture o ota ub'c- S I Id Commi�aioo co 242227
""'•� JACOUELYN. L. WEBER
d^ etplreso7rnrzozz
Commissio
Notary Public, or is
Ai$eo'+a••.ea♦j
- Cobb Coun
Commission No.
=• `•'xp,\"• ` My commission Expires
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