HomeMy WebLinkAboutBuilding Permit Application 03/10/2017 FRI 15:41 FAX 561 625 8717 North County Plumbing 2001/002
ALL APPLICABLf INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (�
Date: 3141 Permit Number: 170
RECEIVE®
Building Permit Application MAR 10 2017
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
Address: 638 Beach Ave
Legal Description: River Park unit 2
Property Tax ID#: 3419-510-0073-000-3 Lot No.17
Site Plan Name: Block No. 11
Project Name: Dlelmann
Setbacks Front Back: Right Side: Left Side:
MR
Replace 30 gal elec water heater
a
itiona wor to e e orme un ert is permit—c ec a appy:
HVAC Gas Tank ❑Gas Piping —ShuteQ Windows/Doors
Electric 0 Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 795 Utilities: Sewer I]Septic Building Height:
EFR.' INNIFNEW
R
Name Ross Dielmann Name: AnthonyAgrusa
Address: 66 Sherwood Street Company: North County Plumbing
City: Clifton State:NJ Address: 2647 President Barack Obama Highway
Zip Code: 07013 Fax: City: Riviera Beach State:Fi
Phone No.772-380-2987 Zip Code: 33404.4119 Fax: 561-625-8717
E-Mail: Phone No. 561-625-9414
Fill In fee simple Title Holder on next page(if different E-Mail: Northcountyplumbing@hotmail.com
from the Owner listed above) State or County License: CFCO26530
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
03/10/2017 FRI 15:42 FAX 561 625 8717 North County Plumbing
1 2002/002
r}
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:
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 Nolp of Commencemen .must be recorded andS!gon the jobsite
before the first inspection. If you i d to obtaining,consult with tender rney before
commencing work or re rdin ou oti ommencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDAr
COUNTYOF it� COUNTY OF 6( � G .
The fp{rgoing instr P t was cknowledged before me The for ng instru nt was knowledged before me
this day of 20 f2Uy this for
of� .20 17 by
��rsa SAa4hm�
( ame o person acknowl (ng) (Na f person ac owledging)
(Signature of Notary P c-State of Florida) A(.fgnWre of Notary PuW--State of Florida)
Personally Known 'f' ti Personally Known a " �luced 18'L�4f�Rffal:QtiNSON
Type of ldentificat10 P, ;t �t atut a Type of Identification t Notary'Pubi(e-State at Florid
Notary Public-State of Florida ;y
Mission#FF 197676
Commission No. =• •> Com11*0#FF 197676 Commission No. 'moo d; MY Cor►rk[Apes Apr 20,2019
It} ` MY Borttttt,£xpkea Apt 24,2419 Bondedtlrough National�ryAsM.
"""h'•.�j1i111111�t
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS