HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO 62 ACCEPTED
Date: I' Z�J' j' 8 SCANNED Permit Number: 1361
BY
I St. Lucie County
Building Permit Application
Planning and Development Services I JUL 2 5 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Perrr
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial SIGN Residential" 4
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line II
PROPOSED IMPROVEMENT LOCATION:
Address: 65951 CS �&� \_I�r-� � \ , C k-e
Legal Description: WHITE CITY GARDEND -AN UNRECORDED PLAN IN SEC 15-36-40, LOTS 11, 12, 13, 14 AND 15
LESS RD R/W (1.21 AC 52.708 S.F.)
Property Tax ID #: 3415-502-0011-000.4 Lot No.
Site Plan Name: P S L Burger King & Litterman Block No.
Project Name: Burger King
Setbacks Fri
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: III
( &I _C tTA t.(— (AP\"_
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S l CTrS S D tit 5 6�e r—(.4 I (n) r g 1r
a F- 1-He- )Scslc-zr/3&- — F-AC,U
CONSTRUCTION INFORMATION: III
11HVAC LJGas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
Z o0
Gas Piping
I__IShutters
❑Windows/Doors
Sprinklers
11 Generator
1:1
Roof
=
Roof pitch
S Ft. of First Floor: _
Utilities: Sewer o Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Seven Real Estate Holdings LLC
Name: David Wayne Allen
Address:117 Hidden Glen Way
Company: Allen Industries of North Carolina, Inc.
City: Dothan State:AL
Zip Code: 36303 Fax:
Phone No. 954/909-8141
Address: 11351 49th Street North
City: Clearwater State: FL
Zip Code: 33762 Fax:
Phone No. 727-573-3076
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: renee@signpermitsplus.com
State or County License: ES0000150
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
4 7�'
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 lender or an attorney before
commencing work or recording vour Notice of Commencement.
re of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORID
COUNTY OF
Thefo nginstru t s acknowledge efore me
thi�—day of w 20L by
� a PUS
Name of person raking statement
K Personally nown 1/ OR Produced Identification
Type of Identification
Signature of Contractor/License Holder
STATE OF FLORI
1 c� COUNTY OF xSL ��
The for mg instrume was acknowledged before me
s—day of , 20(S� by
k )Z�,yZc� l Al . ►� � lQ�l
Name of persons aking statement
Personally Known ✓ OR Produced Identification
Type of Identification
Sig atu a of Notary Public- 5 a
of Florida)
(Signat re o Nootaary� Pubbli�c-
Om ssion No.
;>ow'%°�•{Se�lJ1ANEMHYDEary public -State of Florida
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Commission R fi56
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Commission P GG072856
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