HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPiE rcD FOR APPLICATION TO BE ACCEPTED
Date: 9/28/17
_ t ol}) SCANNED Permit Number: 1
G of
St. Lucie County RECEIVED
Building Permit Application OCT U 5 2017
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
PERMITTING
St. Lucie County, FL
Residential
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
PROPOSED IMPROVEMENT LOCATION:
Address: 4fi4# FRWZmbrooke4ar. .3RA /gDhQ-,ti kv 51-4 Fu.k Q'iev(. F1 Rff?_
Legal Description:
Property Tax ID#: "P yza - if 0006-- 0/Q—
Site Plan Name: City Electric Supply
Project Name: City Electric Supply Signage
Setbacks Front 488 Back: 55 Right Side: 1070 Left Side: 377
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: % / III
Install (1) 15" internally -illuminated City Electric Supply wall sign on the front North
vinyl yvill also be installed
wall sign will be connected to existing
„rN
vationkInstdH )
A set of door
circuit.
I CONSTRUCTION INFORMATION:' I
LJHVAC L 1 Gas Tank LJGas Piping LJ Shutters
Electric Plumbing []Sprinklers k�\ I�Generator
Total Sq. Ft of Construction: 77.36 r9��b . Ft)))Ft.I of First Floor: _
Cost of Construction:$ 4251 Utilities:LJSewerE]Septic
Windows/Doors
11 Roof = Roof pitch
Building Height: 16.5'
OWNER/LESSEE:
CONTRACTOR:
Namt_
Address:;—VO— ox 6yCb�/3
City:' 1/;vn State: FL
Zip Code: 312 9Cy Fax:
Phone No
E-Mail: daleboyd772@gmail.com
Name: David W. Jackson (Qualifier)
Company: Anchor Sign, Inc.
Address: 2200 Dische r Ave.
City: Charleston State: SC
Zip Code: 29405 Fax: 843-576-7209
Phone No. 843-576-3209
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: crobertson@anchorsign.com
State or County License: E,90000291
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required..
SUPPLEMENTAL CONSTRUCTI IEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: McFarland Engineering
MORTGAGE COMPANY: _ Not Applicable
Name:
Add reSS: 464 N. Hiddenbrooke Dr.
Address:
City: Advance State: ND
Zip: 27006 Phone261-a1a;74a9
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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, l 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
rnmmpnrine work or—m-mrdine vour Notice of Commencement_ n /�
w�
e." r
Dt
Signature of Own Less /Contractor as Agent for Owner
Signature of.Contr nse Holder
STATE OF SOUTH CAROLINA
STATE OF SOUTH CAROLINA
COUNTY OF CHARLESTON
COUNTY OF CHARLESTON
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this lath day of September 20 17 by
this, 26th day of September 201� by
David W. Jackson
David W. Jackson
Name of person making statement
Name of person making statement
Personally Kno x OR Produced Identification
Personally Knyy x OR Produced Identification
Type of Identi cati n,
Type of Ide #ifica ion
Produced (Hirriselo
Produced( imself) '
A. HOPKINS
;.ri"
(Signatu 9
(Signature - fA
'•° ` -d/`' My Commission Expires 1210112025
�;a°
Seal
Commission Expfa10112025
Commiss' n r'ra:'�"°""
Commissio No:'••+,��."
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
I (L
DATE
COMPLETED
Rev.8/2/17