HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9.22.15 Permit Number:
SCANNED
BY
Building Permit Application St. Lucie County
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 APPLICATION FOR:
J.
PROPOSED IMPROVEMENT LOCATION s • 4' ,. ,. "
Address: 7139 S US HWY 1 PORT ST LUCIE
Legal Description: ATTACHED
Property Tax ID #<: 3422.211.0010.000.6
Site Plan Name:
Project Name: BINGO MADNESS
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
('DETAILED DESCRIPTION DF WORK III
INSTALL ILLUMINATED WALL SIGN, CONNECT TO EXISTING ELECTRICAL SUPPLY
'CONSTRUCTION INFORMATION:.
E1HVAC LiGasTank
❑✓_ Electric 0 Plumbing
Total Sq. Ft of Construction: 15
Cost of Construction: $ 2,320.00
nrs per IT] u—cnecx au
1
Piping I_IShutters
nklers ElGenerator
_ S Ft. of First Floor: _
Utilities: Sewer Septic
❑ Windows/Doors
Roof
Building Height:
DOWNER/LESSEE:; �7�: _.
CONTRACTOR:
Name PORT ST LUCIE-PLAZA 1:LLC
Name: ROBERTD'GRALAK' ""- ' '
Address:112 PHYCIS CT ; , _'
Company: FLAMINGO. SIGNS; LCC
City: ELMONT. ;,+ State: NY
11003• ' *
Zip Code: F.ax;_..
Phone No.561.929.4890
Address:'4444 SE COMMERCE AVE'
STUART,' "'" " ` ' FL
City: State:_
Zip Code: 34997 Fax: 772.220.7768
Phone No. 772.220.7377
E-Mail: Corey@cc-reg.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: flamingosigns@aol.com
State or County License: ES 12001146
IIIf value of construction is $2500 or more, a RECORDED Notice of Commencement is required. II
-SUPPLE CONSTRUCTION LIEN LAIN INFORMATION
:.: ,...
F
DESIGNER/ENGINEER: X Not Applicable
Name: DAMES PArr
MORTGAGE COMPANY:
Name:
X Not Applicable
Ad d ress: 12201 SE COLBY AVE
Address:
City: HOBESOUND State: FL
City:
State:
Zip:33455' P.hone:772263.26n
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY:
Name:
X Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this —day of SroT f uCJ1.1, 20 _S by
401? e't7 /rA/ic�{k
(Name of person
��acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known I. OR
Type of identification Prow
Commission No.
Revised 07/15/2014
Identification
Notary Publ�"p State of Florida
Rob9ftflRice
My Commission FF 004962
of
STATE OF FLORIDA
COUNTY OF
apse Holder
hl4nr /M
The forgoing instrument was acknowledged before me
this LL day of 20 / S by
/� 00t2T �-ILel r-,f
(Name of person acknowledging)
AEI/�
(Signature of Notary Public -State of Florida )
Known � OR
Type of
Commission No.
Identification
Notr(Qf t io State of Florida
Robert M tee
My Commission FF 004962
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