HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONt; ---I
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ALL APPLICABLE INFO MUST BE COMPLETE%FeAR APPLICATION TO BE ACCEPTED
Date: B-31-2018 NNED Permit Nu
By
St. Lucie COunty
AUG 3 12018
Building Permit Applicatio
Planning and Development Services
By, 6WICUL
Building and Code Regulation Division
2300 Wrginlo Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Sign
PROPOSED IMPROVEMENT LOCATION:
Address: 10OW KINGS HIGHWAY
Legal Description: 12 35 39 SW 1/4 OF NW 114 - LESS ORANGE AV RAFV AND LESS KINGS HWY AND LESS CANAL R/W
AS IN OR 246-2371.247-2861,240-2170 AND 3122-1299- (19.60 AC) (OR1 077-6D6:608:609)
Property Tax ID #: 2312-231-0003-00015 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:
GW-9'�I)REMOVE EXISTING SUBWAY SIGN FACES AND INSTALL NEW SUBWAY SIGN FACES.
CONSTRUCTION INFORMATION:
AdditionalWOrKtOne ertormed under this permit — check all tnat apply:
11H 11 Gas Tank [:]Gas Piping OShutters E]Windows/Doori
ZElectric El Plumbing []Sprinklers ElGenerator 0 Roof Roof pftch
Total Sq. Ft of Construction: Sic Ft of First Floor;
Cost of Construction: $ 6,200.00 Utilities, L] Sewer [:]Septic Building Height:
OWNER/LESSEE: PILOT TRAVEL CENTERS
CONTRACTOR: TEXAS REPUBLIC SIGNS, LLC
NameLANDONLANE
Name: MICHAEL BEVERETT
Address: 5508 LONAS DR
Company: TEXAS REPUBLIC SIGNS, LLC
City.. KNOXVILLE State:TN
Address: 2211 PECH RD
Zip Code: 37939 Fax:
City: HOUSTON State: TX
Phone No. 877-566-7378
Zip Code: 77055 Fax:
E-Mail: NIA
Phone No. 832-865-4662
E-Mail: BFZAD@TEX-ASREPUBLICSIGNS.COM
Fill In fee simple Title Holder an next page (if different
State or County License: ES12001632
from the Owner listed above)
If value of construction is $2S00 or more, a RECORDED Notice of Commencement Is required.
ffta adouciar.,cie
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DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name. 11,5011121.0w
- ve�
Name:
-2�2
Address:
Address:
City: A-P4-AWtff State: Me-
City:
State:
Z i P: 2 7-0 —eve Phone
Zip: _ Phone:
FEE SIMPLE TITLEHOLDER: _X NotApplicable
BONDING COMPANY:
-X-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.
StAucleCoun makes no representation that is granting a ermit will authorize the permit holder to build the subject structure
which is In co lict with any applicable Home Owners Asgocpation 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.
Thefollowing building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen roams 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 youlate)nd to obtain financing, consult with lender or an attoi3lev before
51gnature at Owner/ Lessee/Contractor as Agent for Owner
STATE OF FL
S)fndthre of Ocifitractor/License Holder
STATE OF ELGRWX
COUNTYOF 11JWJ2,r.S
COUNTY OF. Aoo�,i
The forgoing instrument was acknowledged before me
th!sZ&dayof 4vvsv4- 20& by
Name of person making statement
Personally Known &-� OR Produced Identification
Type of Identification
Produced
f�M44-:r-�
(Signature of Notary Public- State of
The forgoing instrument was acknowledged before me
thIsAEdayof g�� 20_& by
Name of persopAlliking statement
Personally Known_ OR Produced Identification
Type of Identification
Produced
Nax�q�
iture of Notary Public- State. of
ssio No. (SeWION LIKE HAI
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