HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
B-31-2018 c6ok
Date:
SCANNED Permit Number:
BY
St. Lucie Countv
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
P PERMII APPLICATION FOR: Sign
P OPO
ROPOSED IMPROVEMENT LOCATION:
Address: 10OW KINGS HIGHWAY
Legal Description: 12 35 39 SW 114 OF NW 1/4 - LESS ORANGE AV R/W AND LESS KINGS HWY AND LESS CANAL RW
AS IN OR 246-2371.247-2861,240-2170 AND 3122-1299- (19.60 AC) (ORI 077-606:608:609)
Property Tax lD#: 2312-231-0003-000/5 Lot No.
Site Plan Name: FLYING J # 622 Block No.
Project Name: FLYING J # 622
Setbacks Front Back: _ Right Side: _ Left Side:
DETAILED DESCRIPTION OF WORK:
oi§W�GNA,- REMOVE EXISTING SIGN TO GRADE AND INSTALL NEW FOOTING AND STEEL FOR
SIGN'fNSTALL NEW DENNYS, FLYING J, SUBWAY AND REUSE THE EXISTING PRICE SIGN.
0
CONSTRUCTION INFORMATION:
Additional worKto pnrt0rmeff_u_nTe_rf0sFeFin_if —ch—eckall apply:
0HVAC GasTank OGas Piping Shutters E]Windows/Doors
Electric Q Plumbing []Sprinklers Generator Roof Roof pitch
� I
Total Sq. Ft of Construction: swernaili L_�,] S Ft of First Floor:
Cost of Construction: 14S f!5m Utilities'll Sewer OSeptic Building Height:
OWNER/LESSEE: PILOT TRAVEL CENTERS
CONTRACTOR: TEXAS REPUBLIC SIGNS, LLC
Name LANDON LANE
Name: MICHAEL B EVERETT
Company: TEXAS REPUBLIC SIGNS, LLC
Address: 5508 LONAS DR
-City: KNOXVILLE State: TN
Address: 2211 PECH RD
City: HOUSTON State: TX
Zip Code: * 37939 Fax:
Phone No 877-56r-7378
Zip Code: 77055 Fax:
E-Mail: NIA
Phone No. 832-865-4662
Fill In fee simple Title Holder an next page ( If different
E-Mail: BRAD@TEXASREPUBLICSIGNS.COM
from the Owner listed above)
State or County License: E812001632
if value of construction Is $2500 or more, a RECORDED Notice of Commencement Is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGWER_/ENGIR'E0E- Not Applicable MORTGAGE COMPANY: )C Not Applicable
Name: ' _5'e� we-5w4ep ame:.
Address: 49�7,v AddreSs:
City: ;I-P.-AWCC State: Aore- City: —State:
Zip: 7- Phone 29/ - Q - 24eA!v Zip: _ Phone;
FEE SIMPLE TITLE HOLDER: NotApplicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _k-Not
Address:
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 Court makes no representation that is granting a ermit will authorize the ermit holder to build the subject structure
which is in co llict with any applicable Home Owners AssocFation rules, bylaws or an9covenants 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 d to obtain financing, consult with lender or an att y before
commericioR work orjasordi =ou Notice of Commencement.
,Signature of Owner/ Lessee/Contractor as Agent for Owner
S)(nift4re of Co6tractor/License Holder
72
_rlromao
STATE OF 14�9M
STATE OF FJA)R=
COUNTY OF lAwie".0
COUNTYOF A4907"1
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thisZff_dayof Agivs,,'- 20_4 by
thisjMdayof A.-ple- 20_& by
Name of person making statement
Name of perso aking statement
:i��CR
Personally Known OR Produced Identification
Personally Known Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of
(Signature of Notary Public- State of LLGFid&
rw
Commiss LUK
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Ido nission Nc solm"I", MkftlI)LLJKE HALTOM
,;No,, 'Notary Public tateof
exas 1,6 15 �Li,—Io_ �0 - Notary Public, State of Texa
Cc . mm. Ex . pir s 4-D9-
022 .... Comm. Expires 04-09-202
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1MURU"MMOSOR
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COUNTER
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REVIEW
REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
ALL APPLICAB.LEMFO Wit BE COMPI.Mb �ORAPPUCAMON TO BE ACCEPTED
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Per Nuffiber: Gi-OlQ�1
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RECEIVED
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06hiltA AUG 3 1 2018�
Build.inj
ep; 5rivIces ST. Lucie Cou*, Permitting
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Phj6ne. (m,41 A S!iTakt(772)A02-IS78,
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Phone No. 877�"077374
40 Code:.
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Fill in Wesk6phi-Thlemaideian next ppp
(I dlfkrent_
'from"thebwner-fisted.ab9ve) SWwdr-O
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DESIGNER/ENGINEEP. Not Applicable
MO_ E COMPANY— �_Poi'App . licabig
Name. W?__rAeLeL3
1. . —
I .... I 11�
Name:--.
Address- AWJfAr —
Address:
city. -;4r,"Wee State- Ao'e-
City*, State
zipi Phone a �174125P
Zip: Phone:
FEE.SIMPLETITLEAIDUDiER: k lj�table, BON)DINig COMpANy-. Not Ap,
_NotAp�
Name: Name:
I I' —
Addreii7,,_�, Address:
city:;
zip. Ph rie: ZIO: Phone:
OWNEOCCINTRACTOR AFFID.VIT* Appli6tion ishereby madi�to]9btain g;p§rmit,to dothe work' and itistallatiofi at indicated,
L
'
I-ce rtIN. tha.t*, w6rk-o( instal lation h;jsccmm&kced Oil4ri:6 the.l
ssuance ofa permit.
'St. Lube,Cion, make'sn 6 1 represeniation that is granting apefOMIAW1 aui6rize,thevermit holderto build the subject -ftructtire
which Is n c nf lrgtgl�tuhiany applicable Home Owners Associat bylaws
on:ru es�
r, , or and covenants that may restrictor prohibit such
structure �se h . Withyour Horne Own6rsAstociation and !kviewyourdeed for-any'restr ctions which may aliply.
:In ronsideration'ofthe granimig of this requested permit, I.do�herebyagree�jhat I wi I lijifall resocts, lieffdrrn�thd wor - k
in:accordanc.e witWthe�a0ptoi4eciplans; the.F.1964a'bi' 11difig-Cdcles and k
u LYcie County Amendments.
The�fololowmrgbi)llolng Ie,rrn, it'ap p'lica"tio-ris ate exemptfrom=dergoing afull-conturiency review: room addhi qnp�
acc ss rst ucI6 res,1sWlT!qJn' ' I ' sscfeb ' "s -d;'-
9.09 Is, 100cqsi Wallis, P ition nroo,m an !accessory us�s to another non�reeldenual%use_�
iw,A"R--N-IN,G,T-O---0,-W,N,ER-,.Yo rfalluretbRdeordiN dtice cifComfinencement I -may result In,your,paying,twice for
lrnom�erftenfs toyourpropeptyi,A,Notice of Commencement must,bd recorded and p6stecl on thL'Icibsite
- , . ,
-y,,du, -to
beforo'thelfirsi:!6904aicifi. if d obtal , n
fin ancin ig,� c , on suit with lender or-art.atIgnkef4efore
commgQ�19k*�rk'oVMrd 6u Noticocif C6hnm6r166r?iefit..1
ig.n.Rtu(6i).fPWn6r/,Li�ssL4��/`CdhtMddy�'s-Ag6ntfo'r,OWner
�rz
_S)_9rAt(jre.of Cofiti-actor/Ucense Holder
-
i STATE 6F FAM,
STATE'OF ELDROX
c6bNTv F, J��j�_
"COUNTY61F
The'forgoing instrument was acknowledgedbefore:rne
-
The'forgoinginstrument mra 5;.cR00Wl0d&ed,befo M me
I.- / _
,this day of AgjLki 2011 by
j
�.d -.11 11 11.
this ay of- 142� ?o�_&by
:iw
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N a m4`61' per!ipn
'Personal m4kifij,statmerit.
Personally Known _6�--'blk Pr6iluced idendtation,
-0R*cdUce4 idefit
Ty0q bifidentificatiow
Produced
Produced
(Signiture.of-4ota," Oublic-5tat
, 04�fl
S N'L KE HALT
Commilssion No.
0 loldh N WKE:HALTOM'
oterY PUbllb,, state Of Ta)�
§SiD4-09�
022 Comm,� i�xo6ras'0,4�0 9�2022
TONT
TLAN
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ZONING-
_dA_T_E
COUNTER
REVIEW
R , EVIEW
REVI . EW REVIEW
�REVIEW
AECtivitb
DATE
COMPLErED
Rev. 9/2/17