HomeMy WebLinkAboutBUILDING PERMIT APPLICATION. -I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0 ZCiI. I R SCANNED Permit Number:
BY
St. Lucie County RECEIVED
Building Permit Application OCT 2 9 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Sign I I
Address: 7061 S US HWY 1, PORT ST LUCIE FL
Legal Description: 22 36 40 FROM NE COR OF NE 1/4 NW 1/4RUN W ALG N SECLI 42 FT TO WLY R/W US 1
Property Tax ID #: 3422-211-0012-000-0
Site Plan Name: SURTERRA WELLNESS
Project Name: SURTERRA WELLNESS
Setbacks Front Back: Right Side: Left Side:
`DETAILED69 Ct21PT)ON OF:WdhK. "
INSTALL SIGNS M p QV �t r-, is n
Lot No.
Block No.
Huu i LlVndi wurK w ue enmrueu unuer uus per rnu —LneLK au dppry:
rElectric
Gas Tank ❑Gas Piping Shutters Windows/Doors
0 Plumbing []Sprinklers aL� qne atorP-6 —
❑ Roof pitch
Total Sq. Ft of Constructiorn. it S �1 K �S . Ft. First i000
Cost of Construction: $ oc it J JUtilities:�Sewer _Septic Buildi Height:
QINNER/LESSEE
GQNTRAGTOR:
Name PSL PROPERTY HOLDINGS LLC
Name:
Address: 3772 AVALON PARK EAST BLVD #201
Company: MACHIN SIGNS, INC
City: ORLANDO State: FL
Zip Code: 32828 Fax:
Phone No. 813-495-7081
Address: " on e-RD M 14 -7
City: m LM I State: FL
Zip Code: 33147 Fax:
Phone No. 305-694-0464
E-Mail: JRAS225@GMAIL.COM
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: info@machinsigns.com
State or County License: EC13005717
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUP OEO!?ALCONSTRUCT(ON LTEN LAW
I-NEORMATIO1V � P
y
DESIGNER/ENGINEER: Not Applicable
N a m e: PSL PROPERTY HOLDINGS LLC
MORTGAGE COMPANY: _
Name:
Not Applicable
Ad dress: 7061 S US HWY 1, PORT ST LUCIE FL
Address: 3772 AVALON PARK FAST BLVD#201
City: ORLANDO State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: PSL PROPERTY HOLDINGS LLC
BONDING COMPANY: _Not
Name:
Applicable
Address: 1011 ROYAL PASS RD
Address:
City: TAMPA FL
City:
Zip: 33602 Phone: 813495-7091
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 or recording Yeur Notice of Commencement.
Signature o Owner/ Lessee/Contracto s Agent for Owner
Signature of Contractor/License
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
d-
COUNTY OFI
The forggng instrument was acknowledged before me
The forgoing instr as ackno edge before me
this � day of 1 } , 2o—M by
this L'�_5 day of�S,by
'.Min
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known x--' OR Produced Identification
Type of Identification
Type of Identification
Produced FvDL„
Produced
SARAC.PERF2
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Commission#1313196792
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Expires March 14, 2022
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i ature of Notary Pub ic- State of Florida
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7019
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Rev.8/2/17