HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONIPA - ",4
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8-31-2018 SCANNED Permit Number:
BY
St. Lucie County
Building Permit
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
AUG 3 1 2018
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PERMIT APPLICATION FOR: Sign
PROPOSED IMPROVEMENT LOCATION:
Address: 100 W KINGS HIGHWAY 11
Legal Description: 12 35 39 SW 114 OF NW 1/4 - LESS ORANGE AV R/W AND LESS KINGS HWY AND LESS CANAL R/W
AS IN OR 246-2371,247-2861,240-2170 AND 3122-1299- (19.60 AC) (OR1077-606:608:609)
Property Tax ID #: 2312-231-0003-000/5 Lot No.
Site Plan Name: FLYING J # 622 Block No.
Project Name: FLYING J # 622
Setbacks FrontL_ Back: _ Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
VE EXISTING FLYING J & SUBWAY SIGN AND INSTALL NEW FLYING J AND
CABINET.
CONSTRUCTION
0HVAC LiGasTank E]Gas
ZElectric El Plumbing []Spf
Total Sq. Ft of Construction:
Cost of Construction:$ /0
I
Piping Ll S'hutt'ers Windows/Doors
nklers []Generator Roof = Roof plich
S Ft of First Floor:
Utilities'll Sewer []Septic Building Height:
OWNER/LESSEE: PILOT TRAVEL CENTERS
CONTRACTOR: TE:XAs REPUBLIC SIGNS; LLC
Name LANDON LANE
Name: MICHAEL B EVERETT
Address: - 5508 LONAS DR
City: KNOXVILLE State -TN
Zip Code: 37939 Fax;
Phone No 877-566-7378
E-Mail. N/A
Fill In fee simple Title Holder an next page (if different
from the Owner listed above)
Company: TEXAS REPUBLIC SIGNS, LLC;
Address: 2211 PECH RD
City: HOUSTON State: TX
Ap Code: 77055 Fax:
Phone No. 832-865-4662
E-Mail: BRAD@TEXASREPUBLICSIGNS.COM
State or County License: ES1 2001632
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name: X44 FAe"A.)
Name:
Address: 445,,177A'
Addreis:
city: a-V#-'WeC State: Aole-
City:
state:
ZIP: Z74-PO& Phone 2f/-93/3-Nr�.�cs?
Zip: _ �h_one:
.FEE SIMPLE TITLEHOLDER: _k NotApplicable
BONDING COMPANY:
Jr -Not Applicable
Name: —
Name:
Address:
Address:
Cltv:
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.LucieCoun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in co 17ict 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.
inconsideration 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: mom additions,
accessary structures, swimming pools, fences, walls, signs, screen roams and accessary 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 a"y before
commeDcloemarkorrawrdiMou Notice of Commpnrpmpnt
ZZ
,Xignature of Owner/ Lessee/Contractor as Agent for Owner
Sjgrftre of Co6tractor/License Holder
STATE OF F12�
STATE OF FJaROX
COUNTYOF 115wiefs
COUNTY OF_Z-15yozefk
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thisZ&dayof A!4v!s*'- 20_& by
this At day of A2%aggZ 20-& by
Name of person malting statement
Name of perso"king statement
Personally Known &� OR Produced Identification
Personally Known _ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Uorklth
ture of Notary Public- State ofsofflia)
!rw- I
Commission No ism)kSON LUKE HALT
10- Z�wv Notary Public. State of
19on i ission No. MONLUKE HALTOM
xas Public, State
State
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Comm. Expires 4-09-
Z� SNotary of T'e"a
of Texe
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� ID 41-62-1922
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REVIEWS
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COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
I COMPLETED
Rev. 8/2/17