HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: S�c� • 1 Permit Number: n
f o al e t7-(ap, IPZ. C_81
e use FEB 18 2020
Bui Permit Applicatio 'T. Lucie County, Permitting
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: Wall Sign
P�ROPO`SED'IMPROVEJMENTLOCATION R T -
Address: 5053 Turnpike Feeder Rd, Ft Pierce, FL 34951
Property Tax ID #: 1301-615-0221-000-0
Site Plan Name:
Project Name: Liberty Health Sciences
Channel Letters on Wall '. t94 )(QrR„ - 54 ,15s-�7
Lot No.
Block No.
Additional work to be performed under this permit— check all that apply:
—Mechanical GTank GPi ShuttWindDoors
—as —as ping — Shutters — Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 1875.00
Sq. Ft. of First Floor:
�I
Utilities: —Sewer —Septic Building Height:
i d2+ da. t+:c-... •"Y' .iC9 2 —: � x.. , _ - .ry, '�.7�� {°' : <r_.'
OWIVE�R/LESSEE. iQ
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C®NTRAC�T: 4
NamePN Investments LLC c/o Jordan Pascale P L
Name:Jay Berry
Address: loll Rj1- cLo-N cca 91z S \bM
Company:JW Berry Signs
City: Coral Gables State: F
Address: PO Box 491620
Zip Code: 33134-4551 Fax:
City: Leesburg State: FL
Phone No.
Zip Code: 34749 Fax: 352-460-0751
Phone N0352-805-4050
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail Permitting@jayberrysigns.com
from the Owner listed above)
State or County License ES12000309
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
N
SUPPLEMENTAL�CONSTRUCTION
LIEN LiAW] VF,ORMATION
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: Mark oisosway
Name:
Address:
Address:163 SE Midtown PI, STE 103
City: Lake City State: FL
City: State:
Zip: 32025 Phone366-754.5419
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: 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 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 qxapN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CEMENT:'
Sigrj ure of 0 r/ Lessee/Contractor as Agent for Owner
tract Aic se Holder
S' nat,ure)FL
STATE OF FLORIDA
STATE IDA
COUNTYOF �. t 1C,(�,
COON e
The fo oing instrumert as acknowledged before me
this day of 2Q by
The forgoing instrument was acknowledged before me
this 15 day of January 20_�D by
,
Name of Aerson making stta-teem nt.
Name of 'person raking statemeAt.
/
Personally Known OR Produced Identification ✓
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
;tic
Produ
-JL-- /
I
(Signature of NotaryPub ic- State o FI rlda)
(Signature of Notary Public- St
' KAREN S.
Commissi ;Ca °� , N I
id
=�wYP"'••. CONNIELUNN
(($Sion GG 197598
Commission NO. GG 197599 *: #
_a cc a-Notrry Public
•= Commission # GG 207484
; r Expires July8,2022
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7 2, 2022
REVIEW
ERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
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=
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. '
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