HomeMy WebLinkAboutBuilding Permit Application I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date: 5/12/2016 Permit Number: /&�y �y D
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Building Permit Application RECEIVED
Planning a I d Development Services
Building and Code Regulation Division MAY 13 2016
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential Demolition
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED iMPROUEMENI"LOCATICt�1 'f
Address: 117 Hilton Drive
Legal DescrIiption: Shheraton Plaza Unit 2 Replat Lot 30(or 3528-2359)
Property T i x ID#: 1432-805-0030-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
QEl"AILD,DESCRPTION OF WORK
Demolition of House aq
@-#P�'STRUCTdON' FORMAI'lON�_
iUnna work toe nertormed under This permit—check a appy:
11HVAIC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ElPlumbingSprinklers I Generator ❑ Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
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Cost of Construction:$ 000.00 Utilities:Sewer ElSeptic Building Height:
01?1�NER LESS E < `� 4QNTRA'CTR
NamesA440 '::G'�C Ste-` Zu�.� Name: Cheryl Jacquin
Addres yyy�'/L•�� J f�llJ�l iQ0/>EYI /E- Company: P&C Construction of the Treasure Coast, LLC
City: /M^oA) -- Sooeil. f State:jlQ, Address: P•O. Box 4343
Zip Code:1 Fax: City: Fort Pierce State:FL
Phone No!= Zip Code: 34948 Fax: 772-461-0095
E-Mail:will` Phone No. 772-216-8900
Fill in fee'simple Title Holder on next page(if different E-Mail: Pcconstructiontc@aol.com
from the Owner listed above) State or County License: CGC 056649
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUSPLEMENTALGQNSTRUC'f'IQN LiElV LAW INEQRMATIQN
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: I Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: I Address:
City: I City:
Zip: Phone: Zip: Phone:
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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 thepermit holder to build the subject structure
which is in cohflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Plelase 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 strictures,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 you intend to obtain financing, consult with lender or an attorney before
commencing work or recordi our Notice of Commencement.
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_Signature of Owner/Lessee/A Signature of Co r Lice older
,y',�1 ,•"XPr s
STATE OF FLORIDA _ ro; •;�_ STATE OFF LORI '
COUNTY OF �:. .4€ COUNTY OF v LI-7va?
The for oin instrument was acknowledged before me ;;
IF
The forgoing instrument was acknowledged be i�>m* g g g
this J&day of 20 �I b !x�� this Fday of 20�� by �
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�Jpj�t I� 13—= ( �� a MIM
(Name of peison acknowledging) c 9%_ (Name of person acknowledging) w
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(Signature rotary Public-State of lorid (Signature ofc taryyPP blic-State of Florida) �N
Personally KI own / OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 017/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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