HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1' �' i� SCANNED Permit Number: I U O l - Q uno
St. Luce Counter RECEIVED
Building Permit Application JUL 2 5 2018
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 SIGN Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
Address: Ctj_��R - ( A Is" \ e sa,----, , i
Legal Description: WHITE CITY GARDEND - AN UNRECORDED PLAN IN SEC 15-36-40, LOTS 11, 12, 13. 14 AND 15
LESS RD RIW (1.21 AC 52.708 S.F.)
Property Tax ID #: 3415-502-0011-000-4
Site Plan Name: P S L Burger King & Litterman
Project Name: Burger King
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
) PS sT (� C>U-CAf&A-r-,�cic- A-;� A- @ b,L,1 L) E ,
Tl� A : (A) a FCa )
CONSTRUCTION INFORMATION:
❑HVAC ❑ Gas Tank
❑ Electric 1:1 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 2--LI4 D o
Piping
❑_Shutters
Windows/Doors
nklers
❑ Generator
❑
Roof
=
Roof pitch
S Ft. of First Floor: _
utilities: Sewer ❑ Septic
Building Height:
:OWNER/LESSEE:
CONTRACTOR:
Name Seven Real Estate Holdings LLC
Name: David Wayne Allen
Address:117 Hidden Glen Way
Company: Ailen 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
11
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required. _ _ 11
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name:
Address:
City: State:
Zip: Phone
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 ao the worK ana installation ds IIIUn.d ICU.
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
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GVIIIIIICIIUII wu�tnul/7/I c,.vlw„ au, ....,.... ..• ..—". .._..-_..._..-.
Signature of Owner/ Lessee/Contractor as Agent for Owner
ignature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA �. - '' pp ' ^
COUNTY OF ��Ikot1,
COUNTY OF � N-�--I.X-l11�
The fir ping instru wa acknowledged efore me
`�da1y`off
Thkf�oyidrg instrume w acknowledged before me
thiayof`Ic��l,l\�'^20 by
this c_) L
20` by
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Name of person,"king statement
Personally Known L/ OR Produced Identification
Name of persorymaking statement
Personally Known 1/ OR Produced Identification
Type of Identification
Type of Identification
Pro d
Produced
(Sign ur of Notary Public- S
e of Florida)
(Sign ure f NotaryP�uub�bllit t- Sf Florida )
Comm' sion No
+�• �. �._
JANE(f Oil
Notary Public - State of Florida
Comm1 ton No.fJ IJU-i "
cF+^"'", JANEMHYDE
� • Notary Public-Stateof Florida
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Commission# 00072856
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My Ccmm.E><pires Feb 14,2021
'f Commission # GG 072856 '
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Rev. 8/2/17