HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number v O 9 -/
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Planning and Development Services Building Permit Application
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: cuu a. rings nwy
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
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 ,2 �` Sq. Ft..of First Floor: _
Cost of Construction: $ �- Utilities: —Sewer —Septic
_ Lot No.
Block No.
x Windows/Doors
_ Roof Pitch
Building Height:
OVI/NER/LESSEE: ,,
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
Address: PO BOX 5127
Zip Code: 73120 Fax:
City: Chattanooga State: TN
Phone No. 405-463-8931
'Zip Code: 37406 Fax:
E-Mail: Construction_ Utilities Permits@loves.com
Phone No423-894-5480
Fill in fee simple Title Holder on next page ( if different
E-Mail jmartin@jccurtisconstruction.com
from the Owner listed above)
State or County License
.,,,," vw - ,,,,,,C, Y nca.vnucu rvMece or wmmencement 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
MORTGAGE COMPANY: Not Applicable
Name: Harrison French and Associates
_
Name:
Address: 1705 S. Welton Blvd suite B
Address:
City: Bentonville State: A
City: State:
Zip:72712 Phonearaz73-moextzes
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 OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BFFORF RECORDING YOUR NOTICE nE rnmmirwrrmpinr »
f Love's Travel Sto s
C
gn ure -of Owner/ Lessee/Contractor as Agent for Owner
Si ature of Contractor/License Holder
OKLAHOMA
STATE OF F49PAM
STATE OF
COUNTY OF OKLAHOMA .
COUNTY O=cL-`io n
The forgoing instrument was.acknowledged before me
this 16TH day of 1u1y 20_20_ by
The forgoing instrume t was acknowledged before me
_
this 1J_ day of June, 20 ZD by
Crystal Vickers
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Sohn 1t+cA 3L
Name of person making statement.
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Name of person making statement. �1% x_xffe//
Personally Known �_ OR Produced Identification
Personally Known OR Produced Identicatitin ��
Type of Identification
Type of Identification — NNE�SE
Produced
Produced T NNE5Sf
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(Sig ure of Nbtary Public- State of a
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(S' ure of No ary Public- State of Florida) T�1 11
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Commission No. (Seal)
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