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Date: 06-06-2019 Permit Number:
SCANNED
BY RECEIVED `,
St. Lucie County JUL ® fl (ird
Building Permit Application
rm,tt;n�i Deparw,tin°
Planning and Development Services- St. Lucia cEittnLy
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMITTYPE: Sign
PROPOSED IMPROVEMENT LOCATION:
Address: 1020 Shorewinds Drive' Fort Pierce' FL
Property Tax ID #: 1425-701-0175-000-7
Site Plan Name:
Project Name: CUMBERLAND FARMS
DETAILED DESCRIPTION OF WORK:
Manufacture and install one pan formed replacement face for existing sign cabinet above store entrance'
Dimensions 2'-113/4" x 8'-1/2"
CONSTRUCTION INFORMATION:
Lot No. 10
Block No. 7
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: 23.96
Cost of Construction: $ 1550.00
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height: 14'-4"
OWNER/LESSEE:
CONTRACTOR:
Name Vsh Realty Inc. % Cumberland Farms Inc.
Name: Jeffery Adinolfe
Address:100 Crossig Blvd.
Company: Atlas Signs Holdings Inc.
City: Framingham State: _
'Zip Code: 01702 Fax:
Phone No.
Address: 1077 West Blue Heron Blvd.
City: West Palm Beach State: FL
Zip Code: 33404 Fax: 561-863-4294
Phone No 561-863-6659
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail gabriele.h@atlasbtw.com
State or County License ES0000204
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.
4.
l31•i2 4
SUPPLEMENTAL CONSTRUCTI N LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER
NDER OR AN ATTORNEY BEFORE RECORDING YOUR OF COMMENCEMENT."
NOTICE
(
as Agent for Owner
Signature of n r ssee1y� o//nnt�
Signature of t or/Lice
otractor
STATE OF
COUNTY OF O ti" J ea_ c�
gQr {H,older II
COUTNTY OF ORS I rv� :Jef)
The for oing instrument was acknowledged before me
this7dayof J L Ill_ 204° by
The for oing instrument was acknowledged before me
this2rdayof 20_6 by
LLe'� (-�-& -L'Y \-Oe__
ae_ � pi ej
Name of person maklrWstatement.
Name of person maki s atm�eent.
Personally Known OR Produced Identification
Personally Known L- OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
u6licStato of Florida
(Sign' re of NofB y �>:,gy5�llla'&Iq° °
Gina Penney
a MY Commsstgn GG 122836
Commission No. 'y-reS07110 1)
Sons
.h,J�,wa.A,nJ`•
(Sign'a ure of Notary utilitw ate t', gf{, on GG 172636
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=os moo ExP�res 0711012021 d
Commission No.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 217/19