HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I.7 LP -:I (p SCANNED Permit Number: no
St. Luce Count
RECEIVED
Building Permit Application JAN 2 6 2016
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
PER.FOITTING
St. Lucie County, FL
Residential
PERMIT APPLICATION FOR: Sign III
F,PRnpngFl1 IMPRnVFMFNT'i nGATInN•. ' ' III
Address: 10642 S US HWY 1 PORT ST LUCIE
Legal Description: ST LUCIE GARDENS 12 37 40 BLK 4 ,
Property Tax ID #: 3414-501.5001.050.5
Lot No.
Site Plan Name:
Block No.
Project Name-' DOMINO'S
Setbacks FrontBack: Right Side:
Left Sided
DETAILED DESCRIPTION OF WORK:
REPLACE EXISTING. ILLUMINATE_D_,W_ALL SIGN WITH NEW SIGN-. CONNECT TO -EXISTING
ELECTRICAL FROM OLD SIGN.
CONSTRUCTION INFORMATION_
rtiona wor to e e orme under tispermit—c ec
a apply:
❑HVAC EJGasTank ❑Gas Piping
_Shutters
❑Windows/Doors
❑✓ Electric Plumbing' []Sprinklers
❑ Generator
❑ Roof
Total Sq. Ft of Construction: 21.1
SrI�Ft.I of First Floor:
Cost of Construction: $ 1,900.00 Utilities: nSewer ❑ Septic
` Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name DOMINO'S
Name: ROBERT D. GRALAK '
Address:10642 S US HWY 1
Company:. -FLAMINGO SIGNS-L4.C-*�
Gitya,P,O,RTrST.LUGIEr.� w s4.^. State:FL
T
Add%r,esss'4444 SE GONIIy LO E�A\%E e
%STUART "^rzz.�.:..,.;,. - .FL
Citya State._
�a Nu:in:�:,;au'¢•�:o>; 3-„.,,off
Zip Code.
Pone IVo `631 8577'?'�; 'r '•` ti
Zip Code_ `7Y' �v �� tiyx^22A.7377
Phone No. 220.7377
E-Mail:' JZEBIBCa?abl"ebrrm' �` �`"
Fill in fee simple Title Holder on next page (if different
E-Mail: flamingosigns@aol.com
State or County License: ES 12001146
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION-
DESIGNER/ENGINEER: x_ Not Applicable
Name: JAMESPAIT
MORTGAGE COMPANY: x_ Not Applicable
Name:
Address: 12291 SE COLBY AVE
Address:
City: HOBESOUNDFL State:
Zip:83ass Phone:2a3.zen
City':. State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: EQUITY INVESTMENT CORP
BONDING COMPANY: X Not Applicable
Name:
Address: 877 JENSEN BEACH BLVD
Address:
City: JENSEN BEACH
City:
Zip:34957 Phone: 334.8133
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 STATE OF FLORID/ „1 ,n
COUNTY OF M61 r+-I 111 COUNTY OF I I l(/( 1' ,
The forgoing instrument was acknowledged before me The forgoing instr ment was acknowledged before me
this �1 day of JQ p IAQT �l 20 ry this day of zoi by
114)ti T Cyr cAu F-06(0,� Q!I04 [a V--
(Name of person acknowledging) I (Name of person acknowledging)
(Signature of No ary Public- State of Flori ) -
Personally Known OR Produced Identification
Type of Identification roduced
Commission No.
Revised
slat: I.. rrodda
Expires 11/23/2019
(Signature ry Public- State of Florida�a )X V
Personally Known y� OR Produced Identification
Type of Identifrcatio Produced
Commission No.'ff (Seal)
936393
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