HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ll
Date: 12/22/2016 Permit Number:
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 Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PFtC+PUSED 1(111PROUEI4!iE,1T LO`CAT)ON
Address: 4002 Avenue L
Legal Description: Sunland Gardens BLK 30 LOT 15
Property Tax ID#: 2405-601-0558-000-0 Lot No.15
Site Plan Name: Block No. 30
Project Name:
Setbacks Front Back: Right Side: Left Side:
DTAILEQ QESCR(PTIC?N OF WORK t,
_,. _"0
I
Demolition of House
CQNST
F,2RUCT) N�iNFOR1IT(ON,
Add
itiona work toe e orme under this permit—c ec a appy:
HVAC Ei Gas Tank ❑Gas Piping _Shutters Windows/Doors
11Electric 1:1 Plumbing Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 3,995.00 Utilities:n Sewer Septic Building Height:
a �
A I�/NER/LESSEE k ,x E °u CONTRACTQi q ,,
F,..:. _
s �.� ,
Name Willie M West&Michelle Pettway Name: Cheryl A jacquin
Address:350 NE Granduer Avenue Company: P&C Construction of the Treasure Coast, LLC
City: Port Saint Lucie State:FL Address: P.O. Box 4343
Zip Code: 34983 Fax: City: Fort Pierce State:FL
Phone No. Zip Code: 34948 Fax: 772-461-0095
E-Mail: 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: CGC056649
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
StE11hENTA Ca15TFl1CTflNIi1tt NFR11A1C# ti
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 thepermit 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.
s
—Signature of Owner/ a ee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �A-LLA c COUNTY OF !�-!N\�,Wyn.t
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_cJZ day of 20 � by this O'day of 20 Ny by
�a �. Jctco�a�n ChenS4\ 'c 4
(Name of person acknowledging) (Name of person cknowledging)
i
(Signature of Notary Public-State of Florida) (Signature of N ary Public-State of Florida
Personally Known OR Produced Identification Personally Known_�OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. TO IIS (Seal) Commission No.�7v208U75 (Seal)
00 Notary Public State of Florida opA!%.- Notary Public State of Florida
Alyssa Modine � Alyssa Modine
Revised 07/1$/2014 a My Commission FF 208475 �, aa� My Commission FF 208475
orEvo Expires 04!14/2019 oro Expires 04/14/2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION ( SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS I'