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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �•'� R'2 OTC SCANNED Permit Number: BY RECEIVED St. Lucie County Baaiic1ing Permit Application MAR 2 8 2018 Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 2300 Urginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1575 Commeri:4 Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III I PR!•]0l1SFn IRAPRf1VFR'AFNT I'G)CATIONc• 111 Address: 100 5C !PL y LA V &\1 N Legal Description: Z1VKQ q)A, � - l7N %T -s yzi SO W tD -*T (fir I or m % foul till- - Property Tax ID#: 'NM 101- � Q-CGRAI - Oa) -S Lot No. Site Plan Name: Block No. Project Name: bccli2 t- syy � I Setbacks Front Back: Right Side: Left Side: DETAILED DE_S,GRIPTION;OF W©RI( %f\-' ak l \1lAml mkcl Writ.,, si 9V) I CONSTRUCTION4NF0'(M�471dN UHVAC L=JGas Tank LIGasPiping LJShutters LX$Electric OPlumbing Sprinklers 0 Generator Total Sq. Ft of Construction: rryy S� tFt. of First Floor: Cost of Construction: $ � 0 0 Utilities: Ft Septic DWindows/Doors 11 Roof = Roof pitch Building Height: OWNER/LESSEE f ONTf7ACTQR _ i' Name Miltpn Name:�1'lE`n 1C:�YylO Address- ?a ?'Oy ' 1C100 Company: Address: I1lAO ��l�fl�ltf4, Zip Cod Phone No. Citv:��14C�-A�i Zip Code: Fax: Phone No. E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: State or County License: If value of construction Isg25uu or more, a KLCURDED Notice of [ommencemenr is requoeo. oc��►nr�,l 5i9 n o1�-o�,z� SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: City: Zip:. FEE SIMPLE TITLE HOLDER: Name: MORTGAGE COMPANY: _)Q Not Applicable Address: City: State:_ Zip: Phone; Not Applicable I BONDING COMPANY: Address: City: City Zip; Phone: Zip: Phone: Not Applicable 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 no :e the permit holder to build the subject structure or and covenants that may restrict or prohibit such 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 recoorind posted on the jobsite before the first inspection. If you intend to obtain financing, consult with I d or an attorney before commencinework of—recordine Your -Notice of Commencement. r^ Signature of Pwner/ Lessee/Contractor as Agent for Owner Signat re of ont ctor/License Holder STATE OF FLOWDqq STATE OF FLORIDA COUNTY OF 1_nQl Q(L�1V $ / COUNTY OF The�grgoin �inst menfu, ftftyas acknowledgggbe�ore me this da of " .V� 20 b The forgiting instrumentwas cknowledge More me this �ayof 20. T Y�rj Cis Lc�ry .b-A �4Off),Qk OQ Name of person making tern nt Name p son making sta t Personally Known OR Produced Identification v� Personally Known OR Proddcdd Identification Type of IdentificatioCi Type of Ide r catio Produced'i_ DONPt`5 L� C2>7� Produced 14)(:-"� - bA VFV1D2V (Signatur of No Public-�1tS'tnat of Florida) (Signature of Nota ublic-State o I ida ) Commission No."Fl-".i.•.UV`o�`"—Se I)"'--"--"-' Commission No. (Seal) l.ARIL i�.a.WRi+^HT i MY COMMISSION # FF794809 F; REVIEWS O; o° s' 9 N '—WPERVF PLANS VEGETATION SEATURTLE MANGROVE COUNTER EVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECENED =- DATE COMPLETED Rev. 8/2/17 Notary Public - State of Florida Commission # GG 017851 My Comm. Expires Aug 2, 2020 :N,lre�..j MY COMMISSION # FF794009 �:;a ;��'EXPIRES May 07, 2p; g blf vi 3aa_pSJ rlomlallou S R ervm¢ con ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Application 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 xx Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III Address: 100 SE PRIMA VISTA BLVD Leeal Descriotion: 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 ILLUMINATED WALL SIGN 11HVAC U Gas Tank OiEd3>0 Plumbing Total Sq. Ft of Construction: Cost of Construction: $ 600 nit - cnecKau apply: Piping _Shutters nklers ❑ Generator _ S Ft. of First Floor: _ Utilities:In Sewer 0 Septic QWindows/Doors 11 Roof = Roof pitch Building Height: r�O�WN�ER/L'ESS,EE�s . "� i C®NTV�RA�G��O ame=ST: LUCIE;ENTERPR_ISE_ S, LLC _ -Name:—STEEHEN M KEMP Address: 1201 Oakfield Drive Company: KEMP SIGNS & SERVICE, INC -City: Brandon State: FL Zip Code: 33511 Fax: Phone No. Address: 1740 HILL AVE 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. SUPPLEMENTAL CONSTRUCTION .::. ._ LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Name: CHRISTIAN LANGLEY Not Applicable MORTGAGE COMPANY: _ Name: Not Applicable Address: 1200 N FED HWY#200 Address: City: BOCA RATON State: FL Zip: 33432 Phone 888-371-3113 City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: _ Name: Not Applicable BONDING COMPANY: _Not Name: Applicable 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 lender or an attorney before commencine work or recordine vour Notice of Commencement. �7 - 1M -A 441- Signature of Owner/ Les ee/Contractor as Agent for Owner Sig u Contractor/License Holder STATE OF FL¢gIp{� I STATE OF FLORIDA COUNTY OF�1 �A D ��94 1 COUNTY OF�YL�:CCA 0,1 ) The forgoing instrument was acknowledg fore me by The going instrygy�n�,,w'as1 cknowledg� b fore me � by this �\day of 20l this day of 20 �ONVCKYY) Name of person making statement N me of person making statem nt Personally Known du Personally Known OR Produced Identification Type of Identification , �����., MARITZA NUNET ��i`'Pbs'•., Public . Stale o1 Florida `�•. Type of Identification �����o MARITZANUNEZ ............ Produced +^o ". Produced .•o Notary C 'sson # GG 017851 ,�•` , , o? blic -State of Florida �: =� o Comm. E><pires Aug 2, 2020 • ; •` Csion # GG 017851 ;�OMhrnirnh O:r��°c'. 9 dedth National Notary Assn. %;, �� Myxp res Aug 2, 2020 ••'•:°•"O`�,,N tonal Notary Assn. (Signature o Notary Pull' -S to of Florida) (Sig Lure of Notary P f' n `omission=No - _ _ ' _ —(Seal)_ _Commissio-n�`lo� _ = - —_ _ Seal REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVI REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17