HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��11
Date: 12-19-201B SCANNED Permit Number:
BY
• St. Lucie Countv RFc>n,Fo
Building Permit Application
Planning and Development Services DEC 3 X1 ?018
Building and Code Regulation Division Permittl '
2300 Virginia Avenue, Fort Pierce FL 34982 St` �We a Coagtment
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Sign III
Address: 10999 US HWY 1 Port Saint Lucie, FL 34952
Legal Description: See Attached
Property Tax ID #: 3414-501-6210-400-9
Site Plan Name:
Project Name: Simple Tax
Setbacks Front Back:
Right Side:
Two Wall Signs: Front Sign-,2.k'7"= 14sf Side Sign- 1.5x 9
HVAC L,1 Gas Tank
Electric 0 Plumbing
Total Sq. Ft. of Construction: `T
Cost of Construction: $ 2,400.00
asT
Lot No.
Block No.
Left Side:
14.14 sf
Shutters ❑,Windows/Doors
Generator 11 Roof = Roof pitch
IV S Ft. of First Floor:
Utilities:
Sewer Septic
Building Height:
OWNER/LESSEE
Name Mondo Properties LLc
Name: Jay Bor y
Address:4237Rigels Way
Company: JW Berry Signs
City: Jensen Beach State:FL
Zip Code: 34957 Fax:
Phone No.
Address: To J)cix; UC-? 1(o2,D
City: Leesburg State: FL
Zip Code: 34749 fax:
Phone No. 352-805-4050
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: Permitting@jayberrysigns.com
State or County License: ES12000309
If value of construction Is.$2500 or more, a RECORDED Notice of Commencement is required.
JK y-453 '= 31.354
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SUPP.,LEMEN,TALaCONSTRUC-,TI(DN4LAIEN
4'•
L'AW INFORMATION
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r..�.r� x:y. fie: 1 ..
'.C!!' 6, �?�N +_
DESIGNER/ENGINEER: _ Not Applicable
Name: MarkGleoa y
MORTGAGE COMPANY: _ Not Applicable
Name:
Add ress: 163 SW Midtom Place
Address:
City: Lek. City State: FL
Zip: 32025 Phone. 386-754-5419
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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 our Notice of Commencement.
Signature of Ow r/ Lessee/Contractor s Agent for Owner
Holder
ST O LORIDA
RIDA
;ZNTYOF—
C U OFF
Theractor/License
forgoing mst:FKpent was acknowledged before me
CQ
The forgoing instr ent was acknowledged before me
this�l`day of � 20_a by
thisa'�lay of 20il by
Jay Berry
Jay Berry
Name of person making statement
Name of person making statement
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
D
&
DO
(Signature of Notary Public- to ofi,084M :9)"
( gnature of NotaryTic-State of Florida )
09ZGU rO0 W000
'�jr
A Loletta H. MalihnM
Commission No. GG1a0260 VOIHO{qSe4901S g. p'
ommission No. GG10026 oP'
dJ�TARY PUBLIC
011Bnd A21VlON °s3`y -yv
oSTATE OF FLORID
VP6
smaq]Ieo'H enalol
Comm# GGt
Fires 6/2,12021
REVIEWS
FRONT
ZONING
SUPERVIS
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REV]
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
�I
DATE
COMPLETED
Rev.8/2/17 1 L
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