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Home My WebLink AboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 0 OJ'o SCANNED BY RECEIVED St. Lucie Count AUG 0 9 2018 Building Permit Application Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial xx Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line iPROPQSE"D�IMPROVEME�T LOCATIQNi: ��,g�, ,- Address: 100 SE PRIMA VISTA BLVD Legal Description: RIVER PARK -UNIT 5 BLK 50 W 10 FTOF LOT 17 AND ALL LOTS 18,19 AND 20 (PARCELS A AND B) (MAP 34/28N) (OR Property Tax ID #: 3419-540-0241-000-5 Lot No. Site Plan Name: Block No. Project Name: CIRCLE K/ SHELL Setbacks Front Back: Right Side: Left Side: INSTALL FACE CHANGE ON ROAD SIGN AcidltlonalworKtoDe errormea unaertn�spermlt—cnecKanrp�apply: ❑HVAC 11 Gas Tank []Gas Piping I Shutters Q Windows/Doors ec ❑ Plumbing ❑Sprinklers ❑ Generator ❑ Roof ❑ Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ 1,500 Utilities:cnSewer ❑Septic Building Height: OWNE /LESSEE ��d _`....K.'� _ ryay;:. CONTRACTOR= , =Name ST_LUCIE.E-NTEF:P_RISES,_L-LC- --Name:—'STEPHEN-M.KEMP Address: 1201 Oakfield Drive Company: KEMP SIGNS & SERVICE, INC City: Brandon State: FL Zip Code: 33511 Fax: Phone No. Address: 1740 HILLAVE City: WEST PALM BEACH State:FL Zip Code:33407 Fax: 561-840-6385 Phone No. 561-840-6382 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: PERMITTING@KEMPSIGNS.NET State or County License: ES0000229 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. MORTGAGE COMPANY: Not Applicable Name: CHRISTIAN LANGLEY Name: Address: 1200 N FED HWY#200 Address: City: BOCA RATON State: FL City: State: Zip: 33432 Phone 888-371-3113 Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable Name: 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, 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 IeAder or an attorney before rnmmpnrine wnrk or recordine vour Notice of Commencement. Signature ofLessee/Contractor as Agent for Owner Signature, ! c tractor/License Holder STATE OF F ' LF STATE FL:I[�Q� , f/� COUNTY O t1 A rrn +CQ(G b�, COUNTY 0:�� \ cyir t Y The forgoing instru t as a knowledged ore me The fo oing instrum t as a knowledge, ore me this day of 20 y this aNday of 201 y kIGLY�(lP1P:� Name of person making statem me of person making statertlent Personally Known OR Produced nt' is do Personally Known V) OR Produced Identification Type of Identificatio ,,,,,"e•. MARITZA NUNEZ Type of Ide tification Produce •••�""Y P Puhlic -State of Florida Produced o•""ra �,� ITZA NUNEZ ' ; •= C mission # GG 017851 'r°.=_ tary Pub c - State of Flori ` ` omm. Expires Aug 2, 2020 "•'%%%P,„,`.k°`O . •e Commis on # GG 017851 , r; ad through National Notary Assn. ";, .°•• y Co ires Aug 2, 20 �..FOF c�°o (Signature of Notary li -S teo onda 5 (Signature if NotaYy Publ' {ommr"ssionTNo-(Seal) rommissiowNoREVIEWS FRONT FRONT ZONING SUPERVISOR P VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW RE EW REVIEW REVIEW REVIEW DATE RECEIVED DATE �p( COMPLETED Rev. 8/2/17 ALL APPLIC BLE INFO MUST PE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � �o rPermit Number: A., RECaft 0 Building Permit AppliCatio n MAR ? S.1010 Planning and Development Services Pormitting Department Building and Code Regulation Division fit, wow ftarlty 2300 Virginia Avenue, Fort Pierre FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercialt) Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: 100 S(F- f1791 i'Lil U 1StIA NV h Legal Description: RN-4c O I)A-L1L 1_-10 - --; bL- 'So W l0 -T rf t OT 1-3 ALIN f-it t_ uITS IS 1(1 Pnyll J� (S�ttg_tr'j,SA Nfs a ) CMM-D ��_12%t CK aD2&-• Us; PropertyTaxlD#: -000-S Lot No. Site Plan Name: Block No. Project Name: i;1J!l�Y— S�--w Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: in�tc��1 CreviZ 00 ro Yl . CONSTRUCTION INFORMATION: diona wor to e e onn un ert isperm —c ec a a apply: �n�JHVAC Gas Tank ❑Gas Piping n_ Shutters ❑ Windows/Doors L7Electric Plumbing ®Sprinklers EiGenerator Roof Roof pitch Total Sq. Ft of Construction, SFt of First Floor: Cost of Construction: Utilities; Sewer 0Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name "fie Name: , I en Address: ftA yCt IJ Company: Van lrt 'AC 11"G. -Address,.-'— City:til? A `ZA�rY� State ZipCode: I[SI Fax:s��u-1,z City 'kofl')'iSd(CL- --- at _ Zip Code: 9-45 ik z1 Fax: Phone No. E-Mail: Phone No, q"0495 rl Fill in fee simple Title Holder on next page (if different E-Mail: =fjj ' from the Owner listed above) State or County License: If value of construction Is $2SOD or more, a RECORDED Notice of Commencement is required. OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtam a permn to uo me worn Y11Y 111= a11o.1 11 »-• I certify that no work or installation has commenced prior to the issuance of a permit. St Lucie Counttyy makes no representation that is granting a permit will authorize the erma noioer io w11u Y1� _.,�, ��•-• which is in conflict with any applicable Home Owners Association rules, bylaws or an covenants that may restrict orprohibit eu structure. Please consult with your Home Owners Association and review your deed for any restrictions which m 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 Lurie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessurystructures, 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 lend?y7r an attorney before commencing work or recorum um rvvuca ur 1.V111111C11AG1.M 'Signature of O ner lessee/Contractor as Agent for Owner signatur or/License Holder STATE OF FLORIDA COUNTY OF ✓ UI Gn�l VQ ( STATE OF FLO A COUNTY OF ` A� t �C OiLC Thefo oinginstrumentwasacknowledged eforeme this��`dayof V\Ctya ` zOJ_by Thofpr�o'mginstrum n w a knowle2dgged,laef�reme thOCo0—day of ��y r' 17:3cr �tr\ cW\ �0Lq N e of n making stateme t Personally Known OR uc d Iden ' Type of Identir on Produced Name of person making state ent Personally Known OR Produced Iden ification � Type of Ide fica'orr}} Produced L �7 C— (Signature of Otary ubli State of Florid „�„�._.----- nj &y1n lmwl G. Y17f3.i Commission N . F t 1f`"Sea� - V (,OMMISSION k FF (Signature of Notary Public- ate of Florida) 'FiT (Seal) LCm fission No. � x EXPIRES May 07.2 ^ �19 REVIEWS FRONT COUNTER NING R VIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEATURTLE MANGROVE REVIEW REVIEW DATE RECEIVED DATE COMPLETED a`oi�di.'•. Rev.8/2/17 ' MARILYN G. WRIGiiT MY COMMISSION t• FF194009 :..._...N01`;' EXPIRES May 07. 2019 0173"9-0-5J rbnuallolaySewua, corn S� . -0 aurary ruouc - state of Florida Vie; Commission # GG 017851 My Comm. Expires Aug 2. 2020 �O'%°iun�^^` 9nntled ihrnunh m�finmi nr^•,... """_