HomeMy WebLinkAboutBUILDING PERMIT APPLICATION,( - � S
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8-31-2018 SCANNED Permit Number:
BY
�--Aj �-g St- Lucie County
CA, sg _�
Building Permit Applicati ECEIVE
Planning and Development Services AUG 3 1 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Fl, 34982 at,
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Edential D
I PERMIT APPLICATION FOR: Sign III
PROPOSED IMPRO
Address:. 100 W KINGS
Legal Description: 12 35 39 SW 114 OF NW 114 - LESS ORANGE AV R/W AND LESS KINGS HWY AND LESS CANAL RAN
AS IN OR 246-2371,247-2861,240-2170 AND 3122-1299- (19.60 AC) (OR1 077-606:608:609)
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: -
I DETAILED DESCRIPTION OF WORK: III
NEW FRONT BUILDING SIGN AS PER DRAWINGS.
IN
HVAC 1:1 Gas Tank EfGas Piping IJ S'hut'ters []Windows/Doors
ZElectric El Plumbing []Sprinklers 1:1 Generator Roof Roof pitch
Total Sq. Ft of Construction: SQ. Ft. of First Floor:
Cost of Construction:$ 5,100-00 Utilities: E]Sewer EI Septic Building Height:
OWNER/LESSEE: PILOT TRAVEL CENTERS
CONTRACTOR: TEXAS REPUBLIC SIGNS, LLC_
Name LANDON LANE
Name: MICHAEL BEVERETT
Address: 6508 LONAS DR
City: KNOXVILLE State: TN
Zip Code: �79M Fax:
Phone No 877-566-7378
Company: TEXAS REPUBLIC SIGNS, LLC
Address: 2211 PECH RD
City: HOUSTON State: TX
Zip Code: 77055 Fax:
Phone No. 832-865-4662
E-Mail: N/A
Fill in fee simpleTitle Holder an next page (if different
from the owner listed above)
*
E-Mail: BRAD@TEXASREPUBLICSIGNS.COM
State or County License: ES12001632
If value of construction Is $2500 of more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGI NEER: Not Applicable
MORTGAGE COMPANY.
Not Applicable
Name: * we-nm"Jj
-A,�,Jft-Awar~AL
Name:.
-2!2
Address: V&WA-1
Address:
city: ZiP*-.WeC - - State: Aore.
City:
State:
ZIP: Z74qm& Phone
Zip: Phone;
FEE SIMPLE TITLEHOLDER: _k NotApplicable
BONDING COMPANY:
JC-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.LucieCoun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in co ilict with any applicable Home Owners Association rules, bylaws or anti 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: 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 a!��y before
commenclag work or-rewrdi =ou Notice of Commencement.
Xignaturre of owner/ Lessee/Contractor as Agent for Owner
S199thre of Co6tractor/License Holder
75
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STATE OF FI:
STATE OF FJJGRWX
COUNTY OF /Y%gw
COUNTY OF—,4-5'9,aefj
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thisZff-dayaf AJ&4-00- 20& by
thisfffdayof !e!� 20_& by
Name of person making statement
Name of perspo.'"liking statement
Personally Known &� OR Produced Identification
Personally Known _ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
A4,a.119L�- —
(Signature of Notary Public- State of 42ift I
—Aqal-u�q�
(Signature of Notary Public- State of!=
Commission No. WA ..... [SeA*SON LUKE HALT
Na Notary Public. State of
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xas ission No. M&UNLUKE HALTOM
Notary Public, State of Texa
tate of Tom
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Comm. Expires 04-09-
022 Comm'.
Expires 04-09-202211
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Rev. 8/2/17