HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q' 1
Date:12/05/2019 Permit Number: I ill�'OagL'
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Building Permit Applicationw
Planning and Development Services
Building and Code Regulation Division
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2300 Virginia Avenue, Fort Pierce FL 34982 "
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial YES_ _ _ _ Residential
PERMITTYPE:NON ELECTRIC SIGN
PROPOSED IMPROVEMENT LOCATION: J
Address: 6642 S.E. US 1
Property Tax ID ft: 3415-501-0065-000-4
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Site Plan Name:
Project Name: MORTGAGE TRAVEL AGENCY
DETAILED DESCRIPTION OF WORK:
INSTALL NON ELECTRIC CHANNEL LETTER SIGN ON FACADE
NO ELECTRIC .
Lot No.
Block No.
I CONSTRUCTION INFORMATION: I I I
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: 2360.00
Cost of Construction: $ 2360.00
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
i Windows/Doors
Roof Pitch
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Building Height:
OWNER/LESSEE:
CONTRACTOR: 'I
11,
Name DOROTHY WILLIAMS
Name:EDWARD LOUDERBACK
Address: 6642 S.E US1
Company:SIGN CONNECTION.
City: PORT ST LUCIE State: _
Zip Code: 34952 Fax:
Phone No.561-951-2038
Address:10249 S.E. LENNARDj
RD
City: PORT ST LUCIE ; State: FL
Zip Code: 34952 ' F;ax: 337-0806
Phone N0335-2441 j
E-Mail: dorothy763@aol.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-MailSIGNCONNLCTIONPSL@HOTMAIL.COM
State or County License 12001360
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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: _ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
N a me: PAUL WELCH
Name:
Address: ISS4S.E. BILTMORE ST
Address:
City: PORTSTLUCIE State: FL
City:
State:
Zip:34984 Phone78"88e
Zip: Phone:
I.
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY:
_Not Applicable
Name: ST LUIE EMILLC,MEP LLC, PPI LLC
Name:
Address: Po sox 17-mm
Address:
City: RIALEAR
City:
Zip: =17 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
"YARNING 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 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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111ghature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTYOF ,e "
COUNTYOF t,s
The forgoing instrument was acknowledged before me
The orgoing instrurj�;entwas acknbwledg before me
this -tl-.aday of��1 �� 20_11by
thl�dayof by
Qn�(11�-.�`,
&i A1�Cid A 4�9uC,.4.A 6-__ok�-
1t7 (.20�
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
S' n ure of otary Public- State of Florida)
ignature of N-State;of Florida )
Commission No. (Seal)
... LASHAHNAING
Commission No >.: .. R4A MINE
,••v'+i'i>:"..: LASHAHNAINGRAM•RAHMING
•.'�Po'�3:; GKPIRE'S:ISSION# GG 1i508U
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ISSION#GG275HO
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DATE
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DATE
COMPLETED
Rev.2/7119 1I /