HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \e, 6 Permit Number: ,tivcq-dada
RECEIV-D Aiu 16 201
OosirAM
BuildingPermit Application SCANNED
pp BY
Planning and Development Services St. Lucie County
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: Alteration
PROPOSED IMPROVEMENT LOCATION`.
Address: 7626 South US Hwy 1 (South Federal Hwy), Port St. Lucie, FL 34983
Legal Description: 22/36S/40E
Property Tax ID #: 3422-802-005-000-2
Site Plan Name: N/A
Project Name: McDonald's Prima Vista CYT
Setbacks Front no change Back: no change Right Side: no change Left Side: no change
DETAILED DESCRIPTION OF WORK
Minor Interior Remo el for CYT
kikone,
Lot No.
Block No.
CONSTRUCTION INFORMATION: '
ditiona wor to ene forme under tispermit—c ec a apply:
0HVAC 0GasTank [3GasPiping _Shutters ❑Windows/Doors
Electric El Plumbing Sprinklers FiGenerator D Roof
Total Sq. Ft of Construction: 90 affected
Cost of Construction: $S ftl�
S Ft. of First Floor: No Change
Utilities:nSewer Septic Building Height: No Change
OWNER/LESSEE::,,CONTRACTOR:
y ,,
Name McDonald's USA LLC
Name:
Address:10150 Highland Manor Dr #470
Company:
City: Tampa State: FL
Zip Code: 33610 Fax:
Phone No.
Address:
_
City: State:
Zip Code: �5333 Fax:
Phone No. —7a — 56
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: IOLtX P(� �21 m'r 4-
State or Co my Licens
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
RECE11 N AUG 16 20t6
SUPPLEMENTAL CONLIEWLAW INFORMATION III
rDESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY. _ Not Applicable
Name: Scott Purdy
Address: 1711 North Himes Avenue
City: Tampa State: FL
Zip: 33604 Phone: 813-353-0035
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: Xenon S A Go Alan Rosenthal
Address: 20900 NE 30th Avenue 7600
City: Aventura, FL
Zip: 33180 Phone:
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
_Not Applicable
St. Lucie Count
yY 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
befo.r�first inspection. If you intend to obtain financing, consult with lender or an attorney before
of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF Hillsboroug
The forgoing instrument was acknowledged before me
this L7, day of 1L.Asli 20 l�by
Tim Chess
(Name of person acknowledging)
STATE OF FL�IDA r'
COUNTY OF 9�f71t.A�1 YU
The foori�gyo'ng instrument was acknowledged before me
this �� a -ay of l 20 by
of person
(Signature of Notary Public -State of Florida ) gnat re of Notary Public - St Florida )
Personally Known V/OR Produced Identification Personally Known OR ProduSId ntification
Type of Identification Produced Type of Identification Produced I J •�
.y+° Nate pis Slate of Florida
Commission No. IZ•LS `t'Ff, Vtk� yypII Commission No.
Me19R�'l'1me 7�—Notary Pablk` �§td �f Florida
A My commission FP osass94
2 , Ashleigh A McFarlane
Revised 07/
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