HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1
Date: 6/8/16 Permit Number:U-10 i�WW-
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Demolition
PROPOSED IMPROVEMENT LOCATION:
Address: 5150 S US HWY 1
Legal Description: WHITE CITY S/D 03 36 40 LOT 40-LESS N 20 FT AND LESS E 30 FT AND LESS RD R/W-(MAP 34/03S)(8.29 AC)(OR 3049-1422)
Property Tax ID#: 3403-502-0069-000-8 Lot No.40
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove billboard structure and materials from property
CONSTRUCTION INFORMATION:
Additional work toe nerformed under this permit—,heck a appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction: $ 1500 Utilities:]Sewer[]Septic Building Height:
OWNER/LESSEE:OUTFRONT Media LLC, ' CONTRACTOR:
Name Conner Milford Name: Jose Miedes
Address:2640 NW 17th Lane Company: Arango Billboard &Construction
City: Pompano Beach State:FL Address: 7915 NW 60 St
Zip Code: 33064 Fax:954-971-5364 City: Miami State:FL
Phone No.954-971-2995 Zip Code: 33166 Fax: 786-483-8735
E-Mail:Conner.milford@outfrontmedia.com Phone No. 786-615-7575
Fill in fee simple Title Holder on next page(if different E-Mail: diana@arangobillboard.com
from the Owner listed above) State or County License: CGC1524177
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. QN14
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY• X Not Applicable
Name: Name:
Address: Address:
City.- State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 jobsite
before the first inspection. If yo ' tend to obtain financing,consult . h lender or an attorney before
commencingwork or reco din yo Notice of Commencement.
s
Si ature of Owner/Lessee/Agent Signature Contractor/License Holder
STATE OF FLORIDA STATE OF FLQR�IDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing ins rument was acknowledged before me
this 6 day of_ TLW� . 20 1<.-by this day of s 20 L�by
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(Nam pers
ackn wledging) (Name of person acknowledging)
(Si0ature of otary Public-State of Florida) '(Signature of No ary PO b ic-State of Florida)
Perso\ona y Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. u e'�i •,j11.1y,
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s�4se�� Commiss � °a' M. ARAN6�-al�
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'•;;��F�d; My Comm. Expires Apr 26,2020
Revised 07/1101'y...•r Bonded rp>gb Natloital Notary Arsn.
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