HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I+7
Date: 12/22/2016 Permit Number: :r 1 0
RECEIVED
Building Permit Application
Planning and Development Services DEP�2 2 �0�6
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
RUPQSED IMPROVEMENTLOCATI{3N
Address: 4505 Juanita Avenue
Legal Description: Harmony Heights Addn Blk N Lots 3 and 4
Property Tax ID#: 1431-701-0244-000-1 Lot No.3&4
Site Plan Name: Block No. N
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION��OFWQRK R
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Demolition of House
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CONSTRUCT)QN IN FC, ON
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Additional work toe e orme under this permit—check a appy:
HVAC Ei Gas Tank ❑Gas Piping _Shutters L1 Windows/Doors
0 Electric 0 Plumbing Sprinklers 1:1 Generator El Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 6,170.00 Utilities: Sewer Septic Building Height:
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Name
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Name Ricky Reaves Name: Cheryl A jacquin
Address:4905 Juanita Avenue Company: P&C Construction of the Treasure Coast, LLC
City: Fort Pierce State:FL Address: P.O. Box 4343
Zip Code: 34946 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 onnext page(if different E-Mail: Pcconstructiontc@aol.com
V.:
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.
SUPPLEMENTAL CQiNSTR1JCTIQN l.IE LAVU I( FQRMATI�N
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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 you intend to obtain financing, consult with lender or an attorney before
commencing work W recording our Notice of Commencement.
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_Signature of Ow essee/Agent Signature of Contract ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF ' � .I AC-1 e
The forgoing instr ment was acknowledged before me The forgoing instrument was acknowledged before me
this day of h 20 l to by this�day of LI C _m b),LY' 20 1�by
Pat+1 �. �ac.taU%(\ ex .1 J ac I
(Name of person acknowledging) (Name of person knowledging)
(Signature of Notary Public-State of Florida) (Signature of otary Public-State of Florida)
Personally Known \/ OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. '�F —I S (Seal) Commission No. (Seal)
o,09r Pu Notary Public State of Florida
ySSa modine o4' Puv Notary Public State Of o a
oa My Commission FF 208475 ?IdO
; Alyssa MOdine
Revised 07/15/2014 �'aoF�oo- Expires 04/14/2019 c My Commission FF 208475
Ex fres 04/14/2019
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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DATE
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