HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 40uaw4".29r2048� eC • .�� ) Permit Number:
I SCANNED
r, BY RECEIVEC
_ St. Lucie County
Building Permit Application
Planning and Development Services LDEC 2018
Building and Code Regulation Division2300VirginiaAvenue,FortPierceFL34982 Permepartmer
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Re ide5tlall tntyr 'FL
PERMIT APPLICATION FOR: Other �?g�a n I Wk /
PROPOSED IMPROVEMENT LOCATION:
Address: 6598 S US HWY 1, Port St Lucie, FL
Legal Description: WHITE CITY GARDENS -AN UNRECORDED PLAT IN SEC 15-3640 LOTS 11, 12, 13. 14 AND 15 LESS rd dws
a
Property Tax ID #:A415-502-011-0004 Lot No.
Site Plan Name: New Burger King Block No.
Project Name: New Burger King
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK- ,
,> x
Retaining wall for new Burger King 0.J n
"CONSTRUCTIONi INFORMATION. Iia =. t _
itiona worK to e nLrforme un ert ispermt—c ec a appy:
❑HVAC 1:1 Gas Tank ❑Gas Piping Shutters n❑ Windows/Doors
11 Electric ❑ _Plumbing ❑Sprinklers []Generator Roof ❑ Roof pitch
Total Sq. Ft of Construction: So- Ft. of First Floor:
Cost of Construction: $ 1800.00 Utilities: Sewer ❑Septic Building Height:
OWNER/LESSEE SeveriRestaurant,LLC
CONTRACTOR: South portConstruction""%
Name
Name: Robert W. Smith
Address:117 Hidden Glen Way
Company: Southport Construction
City: Dorhan State: AL
Zip Code: 36303 Fax:
Phone No.
Address:
City: Clearwater State: FL
Zip Code: 33765 Fax:
Phone No. 727-441-1813
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: sunnne.lasky@speonstwelion.com or mmith@spconstwction.00m
State or Count License: CGC1512872
If value of construction is $2500 or more, a RECORDED Notice of commencement is requirea.
1
SUPPLEMENTAL CONSTRUCTION LIEN, LAW INFORMATION:
DESIGNER/ENGINEER: _
Name:
Not Applicable
MORTGAGE COMPANY:
Name: Robert W. Smith
_ Not Applicable
Address: 6598 S US HWY 1, Port St Lude, FL
Address: 117 Hidden Glen Way
City: Doman
Zip: Phone
State: _
City: Clearwater
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 CountyY 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 jobs'
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before N e
commencing work o"ecording your Notice cement. ern
Signature of Owner/ Lessee/Contractor as Agent for a
Signature of Contractor/License Holder
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STATE OF FLORIDA ¢�¢ a
STATE OF FLORID
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COUNTY OF
COUNTY OF
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The forgoing instrument was acknowledge ore m m
The forgoing instr enter was acknowledged before mere:
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this ,dayof�eC .20 by^:;
this dayGf
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Name of person makingstatement "'^�
Name of person making statement
Personall n OR Produced Identification _
Type of I ntifica o
Produced
Personally OR Produced Identification
Type of Identifica ' n
Produced L_
(Signature of Nota ublic- State of Florida)
(Signature of Not Public -State of Florida) t/
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
to
DATE
COMPLETED
Rev.8/2/17