HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (�T
Date: 1' �`J SCANNED Permit Number:
BY
St. Lucie County RECEIVED
Building Permit Application JUL 2 5 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie county, Permitting
2300 Virginia Avenue, Fort Pierce FL 34992
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
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description, WHITE CITY GARDEND -AN UNRECORDED PLAN IN SEC 15-36-40, LOTS 11, 12, 13, 14 AND 15
LESS RD RfW (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 Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
I N Sfi � vcr 6 /L-a� C.6 n) P/tz—ruAr/ vnf a ti lT-- A T-
b _ f 0 l: — -F (-F/I-(x
(�Z) 6r—C;I-
CONSTRUCTION INFORMATION: I
E1HVAC LJGas Tank
14Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 7,c& y o
aerma—cnecK all appry:
In
^oas Piping _Shutters ❑Windows/Doors
Sprinklers Generator Roof Roof pitch
SqI FFtt.I of First Floor: _
Utilities: LJ Sewer E]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: ES0000160
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
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 orrecordingyour Notice of Commencement.
2lix �CXX�/
) 0D
�)C44 {
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA n
STATE OF FLORIDA
Q Q
COUNTY OF kon 0 4 4 C S
COUNTY OF VL4 c'�
The for ing instrument s cknowledged before me
this day of 201� by
The or��p ng instrument was acknowledged before me
thisday of 20-Wby
p � �i ��
>�n L Q).milU,1,7
Name of pemjo king statement
Name of person making statement
Personally Known *✓ OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Pr uced
Produced
A J
(Si nat re of Notary Public- ate of Florida)
(Sig to a of Notary Public- S e of Florida )
D r••"".1. ��e„tgNEMHYDE
COm fission No. :, N Vic -State Of Florida
^
^•"• (C e.Jq,NEMHYDE
COm 55fOn NO. s "• NdFrY9diic_ State of Florida
�•
-
- commissiono GG 072856
`+, s• Mycomm.FKpires Feb 14,2021
•� • commission# GG 072856
s,�h g My Comm. Expires Feb 14, 2021
'•;'Foa rv?�`• anal Nola Assn
l�liF. •�'•`' tar ASSn.
REVIEWS FRONT ZONING SUPERVISOR
PLAN VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIE REVIEW REVIEW REVIEW
DATE
RECEIVED
COMPLETED
t�
Rev.8/2/17