HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
SCANNED
BY
St. Lucie County
Building Permit Application JANI4 2M
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 4624553 Fax: (772) 462-1578 Commercial X Residential
PERMITTYPE: SIGN
PROPOSED INPROVEMENT LOCATION:
Address: 8631 S US HWY 1 Port ST Lucie FI
Property Tax ID #: 3414.501.1912.500.6
Site Plan Name:
Project Name: COAST SPINE CENTER
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
NSTALLATION OF 1 ILLUMINATED WALL SIGN, CONNECT TO EXISTING ELECTRICAL SUPPLY.
Coast- re Ge(.te-C
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
X- Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: 2.5.6b Sq. Ft. of First Floor: _
Cost of Construction: $ is a Utilities: _ Sewer _Septic
—Windows/Doors
_ Roof _ Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name COAST SPINE CENTER
-Name:RQBERT D GRALAK,
Address:8631 S US HWY 1,
Company: FLAMINGO SIGNS., -
City: PORT ST LUCIE State: _
Zip Code Fax:
.Phone No.770.899.4001
Address: 4444 SE COMMERCE AVE
�city:STUART.., State: FL
Zip Code: 34997 Fax: 220.7768
Phone N0220.7377
E-Mail: nataliebdc@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail FLAMINGOSIGNS@AOL.COM
State or County License ES12001146
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _
N a m e: DAMES PAST
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Ad d ress:l22o1 3E COLBY AVE
Address:
City:, HOBE SOUND
Zip: 3 55 Phone 263.2677
State: FL
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
'Na m e: CROME ST LUCIE ASSOCIATES LP
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
'Add ress:165 FINANCIAL CENTER
Address:
CIty:BIRMINGHAM AL
City:
Zip: 35203 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 Count yy 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
improveme erty. A Notice of Commen us e r nd posted on the jobsite
bef�� a first inspection. I Intend to obtai ancing, consult with lender or ttorney before
c6mmencine work or recording von�ir Notice of 0 +n['nr ^t
STATE OF FLORIDA
COUNTY OF
The for oing instrument was acknowledged before me
this irdayof 7ROrU4nY 20ff_ by
STATE OF FLOiiWAf p
COUNTY OF 14 /L 7 / /-(
The forgoing instrument was acknowledged before me
thisdayof rRK f"ft-f 20LE by
Name of person making statement. Name
Personally Known f OR Produced Identification
Type of Ident ation
Produced
(Signature of Notary Pub -, f FRobe { bhC ate at Floridl
Robert ScrM(sice
072776
Commission No. �� 4 ova E p 9! 3/2021
-0 6�n7 /.-'LA
person making statement.
Personally Known � OR Produced Identification
Type of Identifi Lion
Produced �11 - `� c r y s�
(Signature of Notary Publ' � �y
°°� . Notary Public State of Florida
Commission No. 7 ROD$B09pice
v My Commission GG 072776
os nExpires 06/372021
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