HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: *SCANNED Permit Number:
BY
ftSt. Lucie Coup, 1,c
dkm� 11
Building Permit Application dop 4,f P .
Planning and Development Services St. 1170 4D
Building and Code Regulation DivisionLU�e!
2300 Virginia Avenue, Fort Pierce FL 34982 *1k Y?t
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: IaO SE ;E�—Vcl
Legal Description: River Park - Unit 5 BLK 50 W 10 Ft of Lot 17 and all Lots 18, 19 and 20 (Parcel A and B)
Map 34/28N - OR 2738-175 1
Property Tax ID #: 3419-540-0241-000-5 Lot No.
Site Plan Name: Block No.
Project Name: Prima Vista Shell Reimage
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Relmage canopy to a Shell from a 7-11: Remove existing signage and fascia from canopy. Install new Shell Branded Fascia and red LED
band on 3 sides of canopy. Reconnect to existing electric. No structural change. .1.
[-CONSTRUCTION INFORMATION:
AaarflonaFworktoriegertormed underthispermit heCK all �M apply:
OGasTank c Shutters HV, E]Gas Oipin ❑Windows/Doors
ZElectric Plumbing []Sprinklers Generator Roof Roof pitch
L-F Total S320 LF VEI!ei:fConstruction: S 'Ft of First Floor:
Cost of Construction: $ 6575.00 Utilities: Sewer Septic Building Height:
OWNERILESSEE:
CONTRACTOR:
Name Miller LLC
Name: Anne Dumond
Address: P.O. Box 4900
Company: Canopy Specialist LLC
City: Scottsdale State: AZ
Zip Code: 85261 Fax:
Phone No.
Address. 3301 State Road 574 West
City: Plant City State: FL
Zip Code: 33563 Fax: 813-752-3249
Phone No. 813-703-6844 / 813-352-6163 cell
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: canopyspecialistl@gmail.com
State or County License: CBC1259301
If value of construction is 52S00 or more, a RECORDED Notice of Commencement is required.
SUPRLEMENTAL C0NSTRtXTl0N.LIEN LAW INF,09MATION; :
Name: Stillwater Technologies
Address: 203 Hillscrestst
City: Odando State: FL
Zip: 32801 Phone 407-206-722.2
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 Counri 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 TOO R: Your failure to Record a Notice of Commencemen a result in your paying twice for
improvements yo property. A Notice of Commencement must be cor ed and posted on the jobsite
before the first s e ion. If yoLt�lltend to obtain financing, consult wit en er or an att ney before
commencine w r ecordineNoLlr Notice of Commencement.
Signature otGontraagoKicense Holder
STATE OF FLO IP STATE OF FLORIDA/�
COUNTY OF , hnroouu g COUNTY OF iISbibli ka
The forgoing instrument was acknowledged before me
this%, day of ,4 p&a 20R by
_Anne ,%Jumpy
Name of persoymaking statement
Personally Known ✓ OR Produced Identification
Type of Identification
(Signature
Notary Public - Sjgigalij Florida
00mm. Hion # GG 052140
My Comm. Expires Mar 27, 2021
REVIEWS FRONT I ZONING
COUNTER REVIEW
Rev.8/2/17
The f r oing instrtirtent;a�as acknowledge efore me
this Mdayof/4DYI—'r II '20 by
,¢me - mod
Name of person making statement
Personally Known ee�OR Produced Identification
Type of Identification
Notary Public - State 01 Fh
commission # GG 0521
My Comm. Expires Mar 27.
Bonded through National Well
VEGETATION I SEATURTLE I MANGROVE
REVIEW REVIEW REVIEW