HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONIR
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/22/2015 `_gyp nr
Permit Number: - pm-o
SCANNED l�
BY
St. Lucie County RECEIVED
Building Permit Application
AUG Q 520115
Planning and Development Services "
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Sign }-
PROPOSED I1VIRROVEME,NTIOCATI0�1
Address: 10602 S Federal Highway, Port St. Lucie, FL (Unincorporated St. Luice County)
Legal Description: ST LUCIE GARDENS 12 37 BILK 4 FROM NE COR (more detail attached in survey)
Property Tax ID #: 3414-501-5001-050-5 Lot No.1
Site Plan Name: Block No. 4
Project Name: BILLBOARD CONVERSION TO DIGITAL
Setbacks Front25' Back: 254 Right Side: 25'+ Left Side: 25'
DETAILED DESCAIrPTION`CFF WORK` ' ' "� :``, ; : ° a aJ
REPLACE/REBUILD/CONVERT EXSISTING BILLBOARD STRUCTURE TO SUPPORT TWO (2)
DIGITAL BILLBOARD FACES AND UPGRADE ELECTRICAL SERVICE
x ^e 1 F 4i8 `�.r
CONSTRUCTION.INFORMATION
Y
munder
itiona wor to e e orme t ispermit-check"all appy:
0HVAC Gas Tank []Gas Piping ❑Windows/Doors
_Shutters
R1Electric 0 Plumbing Sprinklers O Generator Roof
Total Sq. Ft of Construction: 400' S Ft. of First Floor:
-Cost of-Construction: $-300;000 Utilities:Sewer Septic Building Height:
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OWNER/LESSEE-.
u. ...a si. .x
.GONTRACiOR
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NameOUTFRONT MEDIA LLC
Name: Ludrick Undo
Address:2640 NW 17TH LANE
Company: OUTFRONT Media LLC
City: POMPANO BEACH State:FL
Address: 2640 NW 17th Lane
City: Pompano Beach State: FL
Zip Code: 33064 Fax: 954-972-2913
Phone No.954-971-2995
Zip Code: 33064 Fax: 954-972-2913
E-Mail: Chris.Ashley@OUTFRONTMedia.com
Phone No. 954-971-2995
Fill in fee simple Title Holder on next page (if different
E-Mail: Ludrick.Lindo@OUTFRONTMedia.com
State or County License: ES0000271
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. /
V
bUPJPLEMENTAL`CONSTRU(?ION.CIEN;LAW INFORMATION:
DESIGNER/ENGINEER: x
Name: Randy Randolph, P.E.
Not Applicable
MORTGAGE COMPANY:
Name:
x Not Applicable
Address: 6036 Bioerrater odve
Address:
City: Lebanon
Zip: 37087 Phone: 615-443-1915
State: TM
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name: EgWryinvestment corporation
Not Applicable
BONDING COMPANY:
Name:
x Not Applicable
Address: 877 NE Jensen Beach Blvd
Address: '
City: Jensen Beach. FL
City:
Zip:34957 Phone:772-33"133
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. 11,ycuintend to obtain financing, consult with lender or an attorney before
_ Signature of
s.L_-a s
Signature of Contractor/License Holder
STATE OF FLORIDA
��� STATE OF FLORIDA r
COUNTY OF COUNTY OF Ey a&_-p�1
The forgoing instruent was acknowledged before me The forgoing instruRnt was acknowledged before me
thisday of U , 20 (Sby I this day of ejU lV\J_ 20 SS by
L QnrldQ 616w)
persona know) clging (Name of person acknowledging )
71 A I
(Signature of No a ubli -State of Florida )
Personally-Known--=OR•Producedldentification -
Type of Identification Pro
M`
Commission No. XxXp(q l'-StaleclParldi
i 1N�`Frpkd h0 20.201
f ComnYNlon 0 FF 094520
Revised 07/15/2014
(Signature of No 1c-State of Florida )
Dersonally°Known---OR=Produced-identification - _
rype of Identification
,�arp»rEhwa diANOY V. l Y
ommissionNo. 'R �1' Notny I Stem of Florida
My Com �ei Fab 20, 2010
.. _ a; Commicslon FF 09/S80'
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
r
COMPLETE
INITIALS
et1'
u
OWNER INFORMATION
NAME:G�ai><c. �n�es I�rv��1T ( o!z/Jert21-+en
ADDRESS: 877 '"'�/6 � Zn sue6 Bea oh ud
CITY: Tensf" JeaC4j STATE: FL ZIP: 3if qS 7
PHONE(DAYTIME): (771) 334—$L39 Email:
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE
FILL IN NAME AND ADDRESS BELOW.
FEE SIMPLE TITLEHOLDER:
ADDRESS:
CITY: STATE: ZIP:
PHONE (DAYTIME): C__).
CONTRACTOR INFORMATION
ST. of FL REG.CERT #: ST. LUCIE COUNTY CERT #:
BUSINESS NAME:
QUALIFIERS NAME: 4W-Wi 4 r 4,;VRO
ADDRESS: 16/�1D �l✓ 7 % 9HN�
CITY: �0�/�9/1'b -%ir/Y STATE: L ZIP: F30 <Se
PHONE (DAYTIME): FAX NOr",r 7-,r.Ze / Email: / • �� • Z.- Q
ARCHITIENGINNEEER: -Ard
ADDRESS: 6 6 L
CITY: L"A's10AI
PHONE (DAYTIME): (_)
BONDING COMPANY:
MORTGAGE LENDER:
ADDRESS:
CITY:
STATE:
ZIP:
IMPORTANT NOTICE: When a.permit is issued and it is not picked up within 60 days after notification
it will be voided and returned to you by mail