HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: % I t5 Permit Number:
dEmosommoommommmoft RECEIVED DEC 0 71015
Building Permit Application
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 yes Residential
SCANNED
St Luce County
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 4500 W. MIDWAY ROAD FT. PIERCE, FL. 34981
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Prooertv Tax ID #: 3406-501-0014-500-9
Site Plan Name: NEW HORIZONS OF THE TREASURE COAST
Project Name: NEW HORIZONS OF THE TREASURE COAST - SIGN REFACE
Setbacks Front Back: Right Side: Left Side:
11 DETAILED DESCRIPTION OF WORK:
SIGN REFACE
Lot No. 9,10,11 AND 12
Block No.
CONSTRUCTION INFORMATION:
AOURIonal worK tODnrormec, under
tispermi —check
all
apply:
0HVAC Gas Tank
❑Gas Piping
_Shutters
❑Windows/Doors
DElectric 0 Plumbing
Sprinklers
Generator
Roof
Total Sq. Ft of Construction: 69 SQ. FT.
S
Ft. of First Floor:
Cost of Construction: $ 2250•
Utilities:nSewer
Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name NEW HORIZONS OF THE TREASURE COAST
Name: JOHN MCQUAID
Address:4500 W. MIDWAY RD.
Company: SHERLOCK HOMES OF THE TREASURE COAST
Address: 10380 SW VILLAGE CENTER DR.
City: FT. PIERCE State: FL
Zip Code: 34981 Fax:
Phone No. 772-468-5600
City: PSL State: FL
Zip Code: 34987 Fax. 866-913-2290
Phone No. 772-343-7600
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: JOHNNYMCQUAID@YAHOO.COM
State or County License: #CGC1516251
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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i 151a:O 11
SUPI"EMENTAL CONS7(iUCTION LjEN LAW Y1FdRMATfON " `
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY:_ _Not Applicable
Name: JOHN HOLT ENGINEERING Name:
Address: ersAWREAVE. Address:
City: WEST PALM EACH State: FL City: State:
Zip: =4 Phone: 55+-7e37e43 Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
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
commencing work or recording our Notice of Commencement.
q0N ti
-"S
_ Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORI99
COUNTY OF COUNTY OF S1- %d.c l�
The forgoing instrument was acknowledged before me The fo ng instru nt as acknowledged before me
this _ day of . 20 _by this y of C 20 LS— by
x�to ca, IC /a d
(Name of person acknowledging) (Nayofon acknowledgin )
(Signature of Notary Public- State of Florida) g Lure of ry b c- State of FI rida ) /
Personally Known OR Produced Identification Pe onally Known OR Pra ced dentification C�
Type of Identification Produced Type of Identification Produced d��
Commission No. (Seal) Commission No. NY R,MILLER
R
Notary Public, Slate of Florida
Revised 07/15/2014 Mycomm.explresJulyl8.2in8
REVIEWS
FRONT
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S RVISOR
REVIEW
PLANS
REV] W
VEGETATION
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SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
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Ali
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INITIALS
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: JOHN HOLT ENGINEERING
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 925 AZURE AVE.
Address:
City: WEST PALM EACH State: FL
Zip: 33414 Phone: 561-7e3-7843
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
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 inspeLcAon. If you intend to obtain financing, consult with lender or an attorney before
commencinialWork or/reVordin—wVour Notice of Commencement.
f f-/il I L/ I _�p
of
STATE OF F _ORA�R STATE OF COUNTY OFOST 14,4,o, lt�
RI
COUNTYOF�4 4
The forgoing inst ument was acknowledged before me
this,�,�dayof�,(' 2015-by
()1i A tn' I
Perfonally K o1 rf OR
Type of Identification Producei
Commission No. 9
Revised 07/15/2014
The for ng instru nt as acknowledged before me
this , y of 20 [_ by
(Sig ture of ary bffc- State of Florida /
Pe sonally Known OR Prorhxq dentification C�
Type of Identification Produced !� �t;
KI�BERLV R. MILLE
Note 009.state ofFlodda Commission No.
Commission 4 EE 210461
KIMUMV A. MILLER
Notary Public, State of Florida
My comm. expires July 18. 2016
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
15 Na_a 11