HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number:
BY
_ St. Lucie County
• _ RECELVE�
Building Permit Application DEC p61al'll
Planning and Development Services pz nment
Building and Code Regulation Division PerS� Lu lecou ty
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial x Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 6598 US hwy 1
Leeal Description: WHITE CITY GARDEND - AN UNRECORDED PLAN IN SEC 15-36-40, LOTS 11, 12, 13, 14 AND 15
LESS RD RAN (1.21 AC 52.708 S.F.)
Property Tax ID #: 3415-502-0011-000-4 Lot No.
Site Plan Name:
Project Name: Burger King
Setbacks Front Back: Right Side: Left Side:
Block No.
DETAILED DESCRIPTION OF WORK: III
Install Menu Board 5 A
CONSTRUCTION INFORMATION: III
�HVAC Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 2200.00
Piping ❑_ Shutters ❑ Windows/Doors
nklers Generator Roof Roof pitch
_ S Ft. of First Floor:
utilities :�Sewer LJSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Seven Real Estate Holdings LLC
Name: David Wayne Allen
Address: 117 Hidden Glen Way
Company: Allen Industries of North Carolina, Inc.
City: Dothan State:AL
Zip Code: 36303 Fax:
Phone No. 9541909-8141
Address: 11351 49th Street North
City: Clearwater State: FL
Zip Code: 33762 Fax:
Phone No. 727-573-3076
E-Mail:
Fill in fee simple Title Holder on.next page (if different
from the Owner listed above)
E-Mail: renee@signpermitsplus.com
State or County License: ES0000150
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION' LIEN' LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: —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 mscauauon as mOILa1CU.
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 antl 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
commenclnwul r icwlulll ............
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF Fh9Rf9A&e0-qlA
STATE OF FLORIDA �7
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COUNTY OF Jekg I1�
COUNTY OF
The forgoing instrument was acknowledged before me
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Name of persoq making statement
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Personally Known OR Produced Identification
Personally Known ✓✓ OR Produced Identification
Type of Identification
Type of Identification
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Commit n No� co G 072856
Commission No.
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
/ a7
RECEIVED
DATE
COMPLETED
Rev.8/2/17