HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: d 1
� RECEI` 7D JUL 112017
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 x Residential
PERMIT APPLICATION FOR: Plumbing
-PROSEDl1ROVMNTLFU
Address: 10725 S Federal Hwy Port Saint Lucie FL 34952
Legal Description: ST LUCIE GARDENS 12 37 40 BLK 4 FROM NW COR LOT 4 RUN S 408.15 FT FOR POB,TH CONT S 672.86 FT,TH E//TO S LI OF LOT 4,580 FT
M/L TO WLY RD RNV LI OF US1,TH NWLY ALG RNV LI 640 FT M/L TO PT 156.85 FT DUE N OF S LI OF THIS TRACT,TH W 276.52 FT TO POB(5.63 AC)(OR 3743-1510;1513)
Property Tax ID#: 3414-501-5004-160-0 Lot No.
Site Plan Name: Block No.
Project Name: 17-0905 Uncle Bobs Storage
Setbacks Front Back: Right Side: Left Side:
O'ETAILED DESCRIPTION OF WORK > n's
., . .. .
Furnish & Install one 2" Wilkins 720 A Backflow to replace existing
CONSTRUCTQN INFORM/ATION
Additional work toe performed under this permit—check all appy:
EIHVAC Gas Tank []Gas Piping Shutters Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 943.00 Sq. Ft.of First Floor:
n Q eO
Cost of Construction: $ /pC /�. Utilities:0_Sewer 0 Septic Building Height:
QWNER/LESSEE yCONTRAGTCt
Name Life Storage Lp Name: Paul Shaughnessy
Address:6467 Main St Company: United plumbing dba Flamingo Plumbing
City: Buffalo State:NY Address: 2781 Vista Parkway Ste K10
Zip Code: 14221 Fax: City: West Palm Beach State:FL
Phone No. Zip Code: 33411 Fax: 561 204 1273
E-Mail: Phone No. 561 784 9428
Fill in fee simple Title Holder on next page(if different E-Mail: info@flamingoplumbing.com
from the Owner listed above) State or County License: CFC1426338
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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5UPPLEMENTAL COTRUCTF(7NLI1V LAW CNFOflN
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DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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 before
commencing work or recording our Notice of Commencem s
_Signature of Owner/1_ Agent Signature of Contractor/License Holder
STATE OF
COUNTY OF ORIDA � ����G4r,Q STATE OF FLORIDAP �Gf
:P� 7 COUNTY OF )
The f r oing instruJr�ent was acknowledged before me The forgoing instrument was acknowledged before me
this day of u" 20 3by this,day of :e:''CLQ 20 1%11" by
2AOUL�1
(Name of person ackn gin (Name of person ackno dging)
(Signatu of Notary Public-State of Florida) (Signa ure of Notary Public-State of Florida)
Pers ally Known 2--OR Produced Identification Personally Known OR Produced Identification
Type of Identificatio Produced �����, Type of Identification Produced
� J�IPRY Pie
,� Pati7cia Gl %mmission No. r� mal) Patricia Guerra
Commission No.�r�� _=�r al '_ COMrwlsslolw .F -
_ 922033 = a_ COMMISSI
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Revised 07/15/2014
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