HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 1-12-22All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/29/2021 Permit Number: okkQ A'GIA
RECEIVED
IL5 JAN 12 2022
,. o
p .40 Mo P Ka Buildin Permit A lication St. Lucie Co—
g p p Permitting ty
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
CBDG Funding
PERMIT APPLICATION FOR: Wait S'I�ms
'FROPOSED'IMPROVEMENT LOCATION: '
Address: 121 S. Kings Hwy, Ft. Pierce, FL 34945
Property Tax ID #: 2311-411-0004-000-1 Lot No.
Site Plan Name: WAWA #5380 Block No.
Project Name: Orange Ave & Kings Hwy
DETAILED'DESCRIPTION`OF WORK,:
Installation of: Wall Sign (44" CQ I D_ East elevation, Wall Sign (35" CQ @ West elevation,
Wall Sign (31" CQ @ North elevation.
Connect all to existing power..
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFO,RMATION:'
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Windows/Doors _ Pond
_ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ �. 1 ��. ®o Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:: '
CONTRACTOR:"
Name WAWA Florida LLC
Name: Priscilla Thomas
Address: 7022 TPC Drive Suite 200
Company: Thomas Sign & Awning
Address: 4590 118th Avenue North
City: Orlando State: FL
City: Clearwater State: FL
Zip Code: 32822 Fax:
Phone No. E-
Zip Code: 33762 Fax:
Mail:
Phone No (727) 573 - 7757
Fill in fee simple Title Holder on next page (if different
E-Mail angela.mcnuttCcDthomassign.com
from the Owner listed above)
State or County License ES0000083
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: _ Not Applicable
Name: Jack Dougherty
MORTGAGE COMPANY:
Name:
Not Applicable
Address: 4590 118th Avenue North
Address:
City:
Zip: Phone:
State:
City: Clearwater State: FL
Zip: 33762 Phone (727) 573 - 7757
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: BP -OK DEV, LLC
BONDING COMPANY:
Name:
Not Applicable
Address: 20411 W. 12 MILE Unit Ste 200
Address:
City:
Zip: Phone:
City: SOUTHFIELD, MI
Zip: 48076 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 conflicts with any. applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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
wiA lender or an attorney before commencing work or recording Your Notice of Commencement.
ature,of Contrae_o - or - Owner Builder as applicable
�,- ,�
STATE OF FLORIDA P1I1teAlas
COUNTY OF
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this _3 _day of ' A,#) 20,a day
PV11s<<l ttCA 01. -rLoW1.^X
Name of person making statement.
n
Personally Kn=tia;;
Type of [dent
(Signature of Notary Pu lic- State of Florida)
`SAY ANGELA MCNUTT
Notary
Commission No. (Sea]) k � Public -State of Florida
J., Commission # HH 096693
My Comm. Expires Mar 5. 2025
Bonded through National Notary Assn.
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Rev 10/12/21