HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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
PERMIT APPLICATION FOR: Plumbing
PROPOSED]M PRbVEM ENT LOCATION
Address: 10125 Crosby PL
Legal Description: POD 26 AT THE RESERVE REPLAT CYPRESS POINT
Property Tax ID#: 3327-710-0017-000-5 Lot No.115
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF
ati
Uxo d uJ odtu heeey Cha()9 e C(-Q a-I e,(P,
CONSTRUCTION INFORMATION. {.;
Additional work toe e orme under tispermit—checka appy:
HVAC Ei Gas Tank E]Gas Piping _Shutters Q Windows/Doors
Electric ✓❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 600 Utilities:CnSewer 11 Septic Building Height:
OWNER/LESSEE.:- CONTRACTOR:
Name Tahseen Izhar&Fauzia Hussain Name: Allen Steinman
Address:10125 Crosby PI Company: Service America
City: Port St Lucie, State:FL Address: 2755 NW 63rd Ct
Zip Code: 34986 Fax: City: Ft. Lauderdale State:FL
Phone No.772-460-1717 Zip Code: 33309 Fax: 954-977-3591
E-Mail:izhar56@aol.com Phone No. 954-979-1100
Fill in fee simple Title Holder on next page(if different E-Mail: epermitsgroup@serviceamerica.com
from the Owner listed above) State or County License: CFC057026
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION if",� V ,� :a
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 our Notice of Commencement.
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Signa&r of Owner/Lessee/Contractor as Agent for Owner Signat f 4Con=tractor/_LUicens_eHoIder
STATE OF FLORIDA[)-) STATE OF FLORIDA
COUNTY OFJL_"K00Jae64 COUNTY OF �1"otoo✓CT
The forgoing instru t was cknowledged before me The forgoing instr nt w s acknowledged before me
this 17 ay of 20 J7 by this i y of rf 20 r' b
_ y
an r� rr?ctn
(Name of rson a n wled ' g) (N me of p r on ackno ledging)
(Signat o of ry ubii( a) (SigKure o Notaryublic-State of Florida)
Personally nY roducE!gW ig rAUi"Gy_ Personally Known
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BX Produced Id`e—nt'iTfiicaton
Type Sheneka HardyType of Identificatio �,hiie..sc2teo Florida of Identificatio
Commission#GG 33870 AS, )_gc
tay u>ic-sTTeorSam
GG33874Commission No. Ib/2V2020 Commission No. Commi%85
o Expires 907/2020
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION- SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS