HomeMy WebLinkAboutBuilding Permit Applicaiton All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED fu 4A
Date: 6/21/21 Permit Number: s
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BUilding Permit AppliCation
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Planning and Development_Services St.Gu
'Building and Code Regulation Division
2300 Yirginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE: Demolition of Trailer
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Address: 5260 Deanna Lane
Property Tax ID#: 1430-702-0031-000-5 Lot No. 7
Site Plan Name: Block No 4
Project Name:
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Demolition and removal of trailer
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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: Sq. Ft.of First Floor:
Cost of Construction:$ 2,400.00 Utilities: —Sewer —Septic Building Height:
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Name_ l `Y–i Name: Cheryl A Jacquin
Addre4�2 A(D _�nn0Q Cdje�(va� Company:P&C Construction of the Treasure Coast, LLC
City:_�� ;e Address: P n Box 4343
Zip Cod_.
O'b i a Le Fax: City: Ft Pierce State:FL
Phone No, Jr`611^ 1+0 22"10477-7 Zip Code:34948 Fax: 772-461-0095
E-Mail: `""i�`"r'-'_._._�.._:__ Phone No 772-216-8900
Fill,in fee simple Title Holder on next page(if different E-Mail pcconstructiontcCDaol.com
from the Owner listed above) State or County License General Contractor-CGC056649
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,50o or more,a RECORDED Notice of Commencement is required.
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 thegranting 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 applicationsare 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 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
p tin/
Signature of Owner/LesseWe6htractor as Agent for Owner Signature of Co a cense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Saint Lucie COUNTY OF Saint Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 21 day of June 20_,Q by this 91 day of .limp 20yq by
Cheryl A Jacquin Cheryl A Jacquin
Name of person making statement. Name of person making statement.
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification I Type of Identification
Produced Produced
(Signature of Notary Public-Sta a of Florida (Signature of Notary.Public-State of Florida)
Commission No.OG ,V l Q o (Seal) Commission NXI 1'�Q k LA Q (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
eV: 00%, Notary Public State of:Flarida=oo1P% Notary Public State of Florida . Nikki Cutler
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M.rnmmission GG 1
Nikki Cutler 891 40a� Expires 02/22/2022
E.Ripires 027227.2022
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