HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONt y a.,(100 • C3 i-"
ALL APPLICABLE INFO MUST BE COMPLETED
Date: 2) =15- /L %/
R APPLICATION TO BE ACCEPTED -raj( $(5G- G 15 - G 3 -7 a S
Permit Number:
I, 1�03—byc�
Building Permit Application
Planning and Development Services I RECEIVED
Building and Code Regulation Division I MAR 1 5 1018
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 I Commercial x ResidentialP@Ffflitt'149-Departmer
PERMIT APPLICATION FOR: To Select froim dropbox, click arrow at the end of line
`PROPOSED 'I'MPROVEMENT LOCATIO"N
Address: 3214 Ave D Ft Pierce FL 34947 I
Legal Description: I
Property Tax ID #: 240821100010003
Site Plan Name:
Project Name: Family Dollar I
Setbacks Front Back: Rightlside:
Left Side:
DETAILED DESCRIPTION' OF WORK: t�
Signage - wall sign (3) _5,�, el wQ,AQ 01N CEIr16rq
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CONSTRUCTION INFORMATION
Additional worK to be nertormed under this permit— checW a —apply:
11HVAC Gas Tank ❑Gas Piping I _ Shutters
Electric 0 Plumbing Sprinklers F]Generator
Total Sq. Ft of Construction: S . Ft. of First Floor: _
Cost of Construction. $ 2300 Utilities: Sewer R Septic
Lot No.
Block No.
WPM=U
QWindows/Doors
Roof Roof pitch
Building Height:
.OWNER/;LESSEE: "'
CONTRACTOR;
Name Family Dollar
Name: Raymond Bums
Address: I
Company: Focus Electrical Services
City: Ft Pierce State:FL
Address: 1800 Whipple Dr
Zip Code: 3447 Fax:
City: State: FL
Phone No.
Zip Code: 32738 Fax: 386-238-1300
E-Mail:
Phone No. 386-238-1711 Ext 106
Fill in fee simple Title Holder on next page (if different
E-Mail: cdaggett@southerneasternlgihtingsolutions,com
from the Owner listed above)State
or County License: EC13003609
II If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. I
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DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name: Family Dollar
Name: Raymond Bums
Address:3214 Ave D Ft Pierce FL 34947
1
Address:
City: Ft Pierce
State:
City:
State:
Zip: Phone
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:1800 Whipple Dr
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I
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 perCnit, 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
Signature ofoVwner/ Lessee/Contractor as Agent for
STATE OF FLORIDA
COUNTY OFBrevard
The forgoing instrument was acknowledged before
this 13 day of 3 , 20_4WLa
Raymond Burns d uA v a
Name of person making statement
Personally Known x OR Produced Ide
ildtgg
Type of Identification
a
a
Produced
w
E
(Signature of Notary Public- State of Florida
Commission No.
mer I SignatureeContractor/License Holder
STATE OF FLORIDA
COUNTY OFBrevard
The forgoing instrument was acknowledged before me
this 13 day of 3 20
4
N
Raymond Bums o o r r
Name of person making statement
o
t,a��-
-
Personally Known x OR Produced Iden
fW*iozo
Type of Identification
o a
Produced
_ " E waEEf
O V
(Signature of Notary Public- State of Florida
Commission No.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED �7 1
DATE
COMPLETED
Rev. 8/2/17