HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I ^ O 1
December 7, 2018 1Iv- II
Date: Permit Number:
otara_ SCANNED
BY
RECEIVED
St. Lucie County
Building Permit Applicatio
DEC 0 7 2918
Planning and Development Services
Building and Code Regulation Division
ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial _V
Residential
PERMIT APPLICATION FOR: Other
PROPOSEDIMPROVEMENT LOCATION:`;`
Address: 6598 SUS Highway 1 Port St Lucie FL 34952
Legal Description: WHITE CITY GARDENS -AN UNRECORDED PLAN IN SEC 15-36-40,LOTS 11, 12, 13, 14 AND 15 LESS RD R/WS-
Property Tax ID#1— 415-502aD11-0004
Lot No.
Site Plan Name:
Block No.
Project Name: New Burger Kinq #29752
Setbacks Front Back: Right Side: Left Side:
DETAILEDDESCRIPTION.OF WORK
Site Lighting for New Burger King
CONSTRUCTION INFORMATION:
-ec
wor to a er orme under is permit -c a apply:
Dona
HVAC 11GasTank []Gas Piping _Shutters
❑Windows/Doors
Electric El Plumbing ❑Sprinklers ❑ Generator
❑ Roof ❑ Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
N/A
Cost of Construction: $ 2000.00 Utilities:nSewer ❑ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:._
Name Seven Real Estate Holdings, LLC
Name: Robert W. Smith
Address: 117 Hidden Glen Way
company: Construction
city: Dothan State: GA
Zip Code: 36303 Fax:
Phone No.
_Southport
Address:1789Calumet Rtrppt
city: Clearwater state: FL
Zip Code: 33765 Fax:
Phone No. 727-441-1813 x19
E-Mall:
Fill in fee simple Title Holder on next page ( If different
from the Owner listed above)
Suzanne. as spcons ru ion.com or
E-Mail:arriU )soconst��ionm
State or County License: CGC1512872
11If value of construction is $2500 or more, a RECORDED Notice of Commencement is required 1value of construction is $2500 or more, a RECORDED Notice of Commencement is required 1
5UPPLEMENTAL CONSTRUCTION` LIEN LAW INFORMATION:
Name: R. Wulbern Architect PA Robert C. Wulbern (AA-0003433)
Add reSS: 4454 Swilcan Bridge Lane
City: Jacksonville State: FL_
Zip: 32224 Phone 904-329-2510
MORTGAGE COMPANY: _ Not Applicable
Address:
City: State: _
Zip: Phone:
FEE SIMPLE TITLE HOLDER: -V Not Applicable I BONDING
Address:
City:
Zip: Phone:
Address:
o'
Phone:
ble
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.;Lucle County makes no representation that is granting a permit will authorize thePermit 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 vour Notice of Commencement. n
i
Signature of Owner/ Lessee/ contractor arAgent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The going ins ument was acknowledge efore me
The f r oing ins ent was acknowledge efore me
this day of 20 by
thist day of 20 by
.
Name of person makingstatement /
Name of person making statement
Personally Known OR Produced '• Identification ✓
Personally Known OR Produced Identification
Type ofldent 'cation
Produced —'nit
Type of Identifica ' n
Produced
d
AA
(Signature of Notary Public- State of Flor
nature of Notary Public- State of Florida )
Yo„ J� EN S. NIELSE
Commission No. AM" l� �'11
°�r;�:StA% Y Florida•Notery Pub
_
mission
•L 4 ,, KAREN S. Njab)EN
. „ ��
Florida
_ •; commission # GG 2074
4
-Notary Public
3• •"c Commission # GG 207484
?:? f �?c My Commission Expir
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My Commission Ex fires
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REVIEWS
FRONT
NING
SUPERVISOR
PLANS
644�ROVE
COUNTER
REVIEW
REVIEW
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17