HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONl
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:4/28/2017 JI;HNIVED Permit Number:
- BY
REM
St. I uric r`nnnti,
Building Permit Application
Planning and Development Services MAY 11 Z077
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 PERMI_M" ia�
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residenti%k i „cie Crbllty, FL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: FLORIDA TURNPIKE MILE MARKER144 FORT PIERCE, FL34984
Legal Description: SEE ATTACHED
Property Tax ID #: 3431-122-0001-0005 Lot No.
Site Plan Name: FT. PIERCE TURNPIKE PLAZA Block No.
Project Name: FLORIDA TURNPIKE FT. PIERCE TURNPIKE PLAZA
Setbacks Front Back:_ Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF INTERIOR SIGNAGE FOR CHICKEN KITCHEN
CONSTRUCTION INFORMATION:
rtiona wor toofirrormea
under tispermrt-check
all apply:
11HVAC
Gas Tank Gas Piping
_ Shutters
❑ Windows/Doors
ZElectric
0 Plumbing ❑Sprinklers
Generator
Roof Roof pitch
Total Sq. Ft of Construction:
ScFt. of First Floor:
Cost of Construction:
pp
$ �-u% Utilities:Sewer D Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name AREAS USA FLTP.CCL Steve Herrmann
Name: Isaac Sasson
Address:5301 Blue Lagoon Dr..Suite 690
Company: Interaktivo Solutions Inc
City: Miami State: FL
Zip Code: 33126 Fax:
Phone No. 305-790-2422
Address: 470 Ansin Blvd, Bay J
City: Hallandale State: FL
Zip Code: 33009 Fax: 954-454-1126
Phone No. 954454-1116
E-Mail: steve.herrmann@areasmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: administration@interaktivo.com
State or County License: EC13005958
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
Ii�
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY:
Name:
5� Not Applicable
Address:
Address:
City: State:
Zip: Phone:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY:
Name:
_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 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
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF L' )("Le
The forgoing instrument was acknowledged before me
this day of Aq(� ` . 20 ::L�by
(Name of person acknowledging )
�. tl Zf
(Signature of Notary Public -State of Florida )
S
Signatur or/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this 1dayof n1 20A!by
�z7s1, C , ate.
(Signature of
Personally Known I OR Produced Identification Personally Know—t-i,_ �R'Produced Identification
Type of Identification Produced T e of Identificaton Produced
"'•• CHRISTINA R B NSON
Commission No. 5� _'� Commission g F ss n No.
_. � mission ftlQtl CAR .HERNANDEZ
?r ,o�� My Commissio .Expires r ` MY COMMISSION N FF 928131
'�`"•, ,:S• .e
Revised 07/15/2014 Bonded Thru Notary Putillo Undanvdt¢rs
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DATEI�I.
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INITIALS