HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application �� SIF
Planning and Development Services PEP.M1171N ,
Building and Code Regulation Division St. Lucie COUnty, �L,
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing
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PROPOSED'I0kO` VEIVIENT LOCATION �
Address: 5 LAKE VISTA TRAIL#203
Legal Description: VISTA ST LUCIE BLDG 5 UNIT 203(OR 1251-2821)-
Property
251-2821)Property Tax ID#: 3422-500-0066-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCR'IPTIC)N;,® WORK��
REPLACEMENT OF CUSTOMER SUPPLIED 30 GALLON ELECTRIC HEATER, BALL VALVE,
AND PERMIT.
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e
Additional work to be ertormed under this permit—check all appy:
❑HVAC Gas TankGas Pi in _Shutters
❑ p g Windows Doors
❑Electric %Plumbing []Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 645.00 Utilities: Sewer L1 Septic Building Height:
O111/NER/LESSEE `' � ' _ COIVTRAC�T®R ` , 0K ' sr '
Name MARGARET PAROLA(EST) Name: RICHARD BASSOFF
Address:5 LAKE VISTA TRAIL#203 Company: ADMIRAL PLUMBING SERVICES, LLC
City: PORT ST LUCIE State:FL Address: 2895 JUPITER PARK DRIVE 4700
Zip Code: 34952 Fax: City: JUPITER State:FL
Phone No. Zip Code: 33458 Fax:
E-Mail: Phone No. 561 746-1180
Fill in fee simple Title Holder on next page(if different E-Mail: christine@theadmiralplumber.com
from the Owner listed above) State or County License: CFC 1426115
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN Li4W 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 thepermit 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 b fore
commencing work or recording our Wice of Commencement.
s
Si of ner/Lesse Agent Sig re • Contractor/L' en H er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALMBEACH
The forgoing instr1pent was acknowledgelfore me The forgoing instrume t was acknow dged before me
this W day of CIU IL- 20 .Tby this day of f•AI- 20 1. –by
(Name of person acknowledging) (Name of person acknowledging)
�eirsonally
ature of Notary Publ' -State of Florida) fersonally
ature of Notary Public-State of Florida)
Known Notary
Produced Identification Known —OR Produced Identification
Type of Identification Produc of Identification ProdgFRY P6q!fj, Notary Public State of Florida �� �a Notary Public State of Florida
Commission No. � a ( n Clark Costa; ission No. CM,,
Su rk Costa
C o My mmisslon GG 032841 �o MY�a{rii IOn GG 032941
OFf�°� Expires 11/13/2020 Expires 11/13/2020
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS