HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 04/04/2017
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: Plumbing
f PROPOSED IMPROVEMENT LOCATION:
Address: 1301 WHITE OAK LN
Legal Description: SILVER OAK ESTATES LOT 11 (0.50 AC) (OR 3251-1992; 3486-706)
Property Tax ID #: 3409-803-0010-000-2
Site Plan Name: 1301 White Oak LN
Project Name: 1301 White Oak LN
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Mo. r-% �Pcoer% me_u' — �'o hOuSt
Lot No. 11
Block No.
CONSTRUCTION INFORMATION: I
Additional work to ben] ertormed under this permit — check all apply:
HVAC L_I Gas Tank []Gas Piping _ Shutters a Windows/Doors
Electric ✓❑ Plumbing 11 Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S�Ft.j of First Floor:
Cost of Construction: $ Vrj0Z oo Utilities: I _I Sewer El Septic Building Height:
OWNER/LESSEE:
Name Pamela A Orna & Rocky A Tenebruso
Address: 1301 White Oak LN
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: James Sinclair
Company: Mr Rooter of the Treasure Coast
Address: 534 NW Mercantile PI, suite 119
City: Port Saint Lucie State: FL
Zip Code: 34986 Fax:
Phone No. (772) 236-7300
E -Mail: james.mrrooter@gmail.com
State or County License: CFC 1425604
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 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 your Notice of Commencement. 1
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signatur of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this _ day of , 20 _by
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this 4 - day of __CLf-t 1 , 20 a by
(Name of person acknowledging )
F
7r aryA�ic-e (Sig ature of Noto rids )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced 111111111100
Commission No. (Seal) Commission NoFFSrI 04 ; P�SSeal) KRISTEN L BENSLE
Notary Public State of F ida
ar, My comm. Expires Mx 10, f020
Revised 07/15/2014 �"' l
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS