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HomeMy WebLinkAboutBuilding Permit Application I ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED/ Date: l9' Permit Number: RECEIVE® Building Permit Application JUN /6. 2016 Planning and DevelopmentServices Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X PERMIT APPLICATION FOR. To Select from dropbox, click arrow at the end of line PROPOSERMRROVE'MENT LOCATIOIf` = ri =. s 2 Address: 5291 Amy Lane Legal Description: Green Acres Unit Two S/D BILK 3 Lot 8 Property Tax l #: 1430-701-0024-000-0 Lot No. Site Plan Name: Block No. Project Name:' Setbacks Front Back: Right Side: Left Side: DETAILED F DESCRIPTION © WORK' Ar- .. . _ .,��., neo.- I Demolition and Removal of Home i I E CONSTRuCTIOw INFORMATIoi 'iz ,, ,. A8d itiona work to M e nertormed under this permit—check all appy: HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors ❑_Electric ❑_Plumbing Sprinklers ElGenerator D Roof Total Sq. Ft of Construction: 1,200 S . Ft.of First Floor: Cost of Construction: $ 2,200.00 Utilities:n Sewer Septic Building Height: N _ `CON`1`RACTOR Name St Lucie County Board of County Commissioners Name: P&C Construction of the Treasure Coast,LLC Address:2300 Virginia Ave Company: P&C Construction of the Treasure Coast, LLC City: Fort Pierce State:FL Address: P.O. Box 4343 Zip Code: 34982 Fax: City: Fort Pierce State:FL Phone No.7172-462-1567 Zip Code: 34948 Fax: 772-461-0095 E-Mail:williamsda@stlucieco.org 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 i If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. i . } 3 a t DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: I Name: Address: I Address: City: State: City: State: Zip. • I Phone Zip: Phone: FEESIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address:.i Address: City: City: Zip: Phone: Zip: Phone: i OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. Icertify 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 you intend to obtain financing,consult with lender or an attorney before commencing work or recording our Notice of Commencement. 6X_ Signature Iof Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF _ }. l 1AC.1+e COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this_�L tlay of .1t t V)4 20-Itt by this 9 day of AL.t xW,. .20� by i (Name of pe*on acknowledging) (Name of persigIn acknowledging) (SignatuM of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known ✓ OR Produced Identification Personally.Known ✓ OR Produced Identification Type of Identification Type of Identification Produced Produced I I Y c Notery Public State of Florida Notpy Pubik State of Florida Commission No. F Alyldine Commission No.Falb$ 'kh Atdildtne j < My Commission FF 208478 My Commission FF 208475 Expires 04114/20194c'tLd° Expires 04/14/2019 f�i REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE j COMPLETED iev. 117-914