HomeMy WebLinkAboutBuilding Permit Application 06/13/2017 12:28PM FAX 7726217882 ALL CITY PLUMBING TWO 1x0002/0003
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEp
Date: 06-12-2017 Permit Number:
R E C E I V-D JUN 13 2017
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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
PROPOSED IMPROVEMENT LOCATION:'
Address: 9628 Windrift Cir
Legal Description: Palm Breezes Club
Property Tax ID#: 2310-500-0087-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front.__ Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install 50 Gal Electric Water Heater
CONSTRUCTION INFORMATION:
Additional work o be performed under t isperms —check a appy:
11HVAC LJ Gas Tank 0Gas Piping _Shutters o Windows/Doors
U Electric Plumbing Sprinklers 11 Generator E]Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$_ 5 C�b.c'�d Utilities:D Sewer L ]Septic Building Height:
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OWNERALSSEE: CONTRACTOR:
Name Chad Ottenbacher Name: Jason Parish
Address:9628 Windrift Cir Company: All City Plumbing Two, Inc.
City: Fort pierce State:FL Address: PO Box 840641
Zip Code: 34945 Fax: City: Port St Lucie State:FL
Phone No,772-631-3038 Zip Code: 34988 Fax: 772-621-7882
E-Mail:_ Phone No. 772`631-1,1,3038
Fill In fee simple Title Holder on next page(if different E-Mail: holly@allcltyplumbingtwops!_com
from the Owner listed above) State or County Licese: CFC1427492
if value of construction is$2500 or more,a RECORDED Notice of Commencement Is req�lred.
06!13/2017 12:26PM FAX 7726217882
ALL CITY PLUMBING Two 00003/0003
SUPPLMEN"CAL CC?NSTRUCTiON L[ENtAiN fNi= RNtA7'lt .N:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE CO PANY: x Not Applicable
Name: Name:
Address: Address: I
City: State: City:
Zip: Phone: Zip: Ishone:
FEE SIMPLE TiTLE HOLDER: x Not Applicable BONDING COMPi NY: x Not Applicable
Name, Name:
Address: Address- I
City: City:_
Zip: Phone: Zip: — --,hone:
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 Ell authorize the permit holder to build the subject structure
which is in conflict with an yy applicable Home Owners Association rues,bylaws or and co enants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for a�y restrictions which may apply.
In consideration of the granting of this requested permit,i do hereby agree that I wit),in 1!respects,perform the work
In accordance with the approved plans,the Florida Building Codes and St.Lucie County Aendments,
The following building permit applications are exempt from undergoing a full concurrent,revlew: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 ma�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 fender or an attorney before
commencing work or recording your Notice of Commencement.
. 5
Signa a of ner/Lessee ontractor as Agent for Owner Sign ur of Contracto Lice older
STA OF FLORIDA STS E OF KORIDA
COUNTY OF COUNTY OF 61 LUO
The for Ding lnstru ent was acknowledge before me The forgoing instrumen was acknowledged before me
this LDL- May of_�dl�. _, 20 acknowledged
this_" day of J0"° 20 _by
1. I
(Name of person acknowledging) (Name of person acknowledging)
(Signature of N to Public-St6fe of Florida) (Signature of Nat ry P1 lit-State orlda)
Personally Known X OR Produced Identification Personally Known X OR Produced identification-
. .._
Mll.�.11glri{_
Type of idenfiificatio *,- Type of Identification Pr
SHELLY A.BARRE iI' � _� SHELLY A WRIM
-� MYCOMMI FF094068 Commission No, +r MEXPI ll�f�,2DIS9
Commission No, EXPI 23,ta1S
} r EXPIRE :Apd 3,2015 I SoededIW"NOVIP4194 VA401WftM
,� Bonded Tiw Nolery Puhiic Une�wr'-sir ,,
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REviEW REVIEW RirVIEW REVlE i REVIEW REVIEW
DATE
COMPLETE
INITIALS
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