HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO musr BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number. 0
Building Permit Application I _bC)15 0 -64-6
Planning and Development Services
Building and Code Regulation Division
2300 lfirglnloAvenue, Fort Pierce FL 34982 FEB 8.2018
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Build.Mise Residential
PERMIT APPLICATION FOR: 'Other C Uf I�LI
1) J) V h
PROPOSED IMPROVEMENT LOCATION:
Address: 7520 S HVVY 1, PORT ST LUCIE, FL 34952
Legal Description: PRIMA VISTA CROSSINGS REPLAT NO. 3 (PB 43-2) LOT 3 (OR 1803-2635)
Property Tax ID #: 3422-858-0003-000-1 Lot No.
Site Plan Name: Block No.
Project Name: 7520 S US Highway I
Setbacks Front— Back. —Right Side: —Left Side: —
DETAILED DESCRIPTION OF WORK:
Kiosk Installation SCANNED
BY
St. Lucie County
CONSTRUCTION INFORMATION:
AdditIona lWo'KILObe errormed under this permit — CheCK all apply:
1jHVAC E]GasTank E]Gas Piping shutters ElWindowspoors
E Plumbing [JSprinklers E3Generator �0 Roof Roof pitch'
Total Sq. Ft of Co�nstru n: 10 S ct ]Ft of First Floor:
Cost of construction: 5,000 Uti ities. Sewer Septic Building Height:,
OWNERAESSEE:
CONTRACT01106,�..,Iin,,
Name Hftw Federal Safts, Bwk Ww PNC BANK %Naftial Tax Seamh LLC
Name: TerranF.rbPmAn
Company: C.M. Freeman
Address' 130 S JEFFERSON ST STE 300
City . : CHICAGO' r Stat6:IL
Address: 471 Lake Bennett Court a
City: Longwood State: FL
Zip Code. : 60661 Fax:
Phone No.
3
Zip Code- 2750 Fax: 407-339-6880
E-Mail,
Phone No.: 407-339-6660
Fill In fee simple Title Holder on next page (if different
E-Mail: cindif@c*nfreeman.com
State or County License: CBC126911647
from the Owner listed above)
If value of construction Is $2500 or more, a RECORDED Notice of Commericeni6rit Is required.
OWNER/ CONTRACiOR'AFFIDVIT: Application is hereby `made to obtalna permit,to do theworkand installation as Indicated.
I certify that no work or installation has commenced prior to the issuance;df 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 con ictwith any applicable Homeowners Association rules, bylaws or and covenants that mayrestrict or prohibit such
structure: Please consult with your Home Owners Association and review your deed for any restrictions which mayapply;
Inconsideration of the granting of this requested permit, I do:heret y agree thatI 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 arid accessory use's to:another non-residential use
WARNING TO OWNER: Your failureto-Record a Notice,of Commencement may result your paying twice for
improvements to your property.,A Notice of Commencement must be recorded and, posted`on theJbbsite
-with
before the first inspection. If you intend to obtain financing, consult lender or an attorney before
.commencingwork or recordin"- our Notice of Commencement.
SignatureofOwner/ Lessee/Contractor as;Agentfor Owner
z
Rev.8/2/17
StJPP EM T CONSTRU
DESIGNERJENGINEER:
Name:
TIGI LIEN A
Not Applicable
INFOR
AT QN.
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:'
State:
FEE SIMPLE TITLEHOLDER:
Name:.
_Not Applicable.
BONDING COMPANY:
Name:
Not Applicable
Address:
Address:
City:
;city:
Zip: Phone:
zip: Phone:
Signature'o Contractor/License.Holder
'STATE OF FLORIDA
STATE OF�FLORIDA
COIINTY'OF 52Mc('oLo
COUNTY OF
The forgoing Instrument was acknowledged before me
The forgoing instrument was acknowledged before me•
this da1y-of , 2015i by
this u+_ day of February
20_ by
1�t
`r (J 1C1GA aO-e�(
Tertari Freeman
Name of person making statement
Name'ofperson makingstaternenf
Personally -Known ✓ OR Produced Identification.
PersanallyKnown ?<
OR Produced Identification x'
Type of Identification
Type of Identification
Produced
ProducedRou
(Signature.o Notary Public -State of Florida)
g afore otary Pulil'
tafe of Florida)
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