HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLEI
Date: iyJaylf2, 2018 AP—Lo
-F-0RA LICATIONTOBEACCEPTED I �Q�'�
RECEIVED p mit Number:.
JUN 2 0 2018
ST. Lucie coon,.
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
.ions
Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
Address: San
Legal Description:
PROVEM ENT LOCATION:
o Ave. -within SLC right-of-way
Property Tax ID #: Wane Lot No.
Site Plan Name: Sheraton Plaza Community Sign Block No.
Project Name: Sheraton Plaza Community Sign
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
see attached C(C> n �J�rt t� T�ht ^ � $C BY D
St. Lucie County
CONSTRUCTION INFORMATION: �' i Yl iDvnd �j; n Cj1, L
un .rY w norm —r pr a t a ann v- -
HVAC L_j Gas Tank
Electric ❑ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
Piping ❑_jjShutters ❑W-ihddws/fJoors '
nklers Generator ❑ Roof ' ❑ Roof pitch
S Ft. of First Floor:
UtilitfestSewer ❑Septic Building Height:_
OWNER/LESSEE:
CONTRACTOR:,-,;;,;
Name St.Lucie,Cou' ty. - ~•
Name: '2I C?�Y �' J1ClP. ?C.
t�—�
Address: nCQ �LjC2iiJ1cin. A;ye
.i
Company: L Gov P�: ., raP` itc t!.onckr y ,o
City: �-fi ? an&D LJ State: rL
Zip Code: S q T 3,l Fax: Lill a - I La 9Lt
PhoneNo. 775-t - 7Pq - tl-Z 9
Address: atel
City: ft. Pi �Qie State: F--
Zip Code: 3YRYGe Fax: yLo,Z — 0553
Phone No. T La5 " 05,1 ? g71. - Y 569
E-Mail:_ `ram ii =521
Fill in fee simple Title Holder on next page (if different,
from the Owner listed above)
E-Mail:
State or •aunty icense C BC 0? 2 D'24.
If value of construction is $2500 or more, a RECORDED Notice of Commencement is regwrea.
ON LIEN
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name: St. Lucie County
\yam
Name: Clem Hai
Address: San Diego Ave. -vemm sic a9mbf-,•,ay
Address:
City: State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY:
Not Applicable
Name: J, L—_(
�\�
Name: \
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:.
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permitto 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 [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
m Improvements to your property. A Notice of ComenceMerit 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
commencin' work ar Yecordin our Notice of Commencement:
Signat re. f Owner/ s /Cohtractor as Agent for Owner
Signaturegf C' " Factor, c Hal
STATE OF FLORIDA
STATE OF F _ORIDA 1
OF St-LUtie
COUNTYOF STO0+�—�—
COUNTY
The forgoing.instrument, was acknowledged before_ me
The forggo��l�S instrument was acknowledge before me
`j:Ffay
day of :: ' 20 by ! -
this of _ii) 4— 20 by
L-P-R2y
Na a of persoi aking statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Iden ' atio(�
Produced
Produced (JrIVCI"S�1��-e1�1S�e
(Signature off '� Publirc "t )
(Sig r 6 PublIALISUM ifflorlda )
CommissiiaJ .CojnmlSsion # CtG
'LG
»_. M' COMMISSK)N IV GG 12737!
Co "` . EXPIRES: 23,2021 (Se
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N�tur PuNb Wdemllaf
6,Rfr
Band SE'ffiN Aaron Notary
REVIEWS
FRONT
ZONING. .
`SUPERVISOR
PLANS
VEGETATION
SEATURTEE •
MANGROVE
COUNTER
REVIEW-
;,REVIEW
REVIEW
REVIEW.
REVIEW
REVIEW
DATE
RECEIVED
a.
`'
/'
PC
DATE
COMPLETED
Y
Rev.8/2/17