HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r�J
Date: 0�7 1: Permit Number: /7a 7-
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Building Permit Application JUL Z l 2Qi7
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
PROPOSED IMPROVEMENT LOCATION:
Address: 8268 SAND PINE CIR
Legal Description: LAKE LUCIE ESTATES PLAT NO. ONE LOT 25 (OR 3328-213)
Property Tax ID#: 3426-7036-0039-000-7 Lot No. 25
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DE SCRIPTION:OFJ"WORK: °..
REPLACEMENT OF 50 GALLON ELECTRIC HEATER, BALL VALVE, AND PERMIT.
CONSTRUCTION•IN FORMAT,ION:L
Additional work toe nertormed under this permit—check all appy.
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric 0✓ Plumbing1:1 Sprinklers E Generator 1:1 Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1,274.00 UtilitiesInSewer Septic Building Height:
OWNER/LESSEE: : CONTRACTOR.
Name FERNANDO SANCHEZ&ELIZABETH DE ZAMORA Name: RICHARD BASSOFF
Address:8268 SAND PINE CIR Company: ADMIRAL PLUMBING SERVICES, LLC
City: PORT ST LUCIE State:FL Address: 2895 JUPITER PARK DRIVE#700
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@theadmiralpiumber.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.
SLfOOLEMENTAL 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
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
commeptcrW work or recording our Notice o o mencement.
7:J4�zs
_Signature of Owner/Lesse ge Signature of Contractor License H e
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALM13EACH
The r g inst n was acknowledged before me The �oing instrument was acknowledged1by
fore me
thi� ay of J W I Ld 20 L'�y this qday of �1 1 i1 20
l chaIrd -b a5 50�f TICJ-) t'CQ 12)Q S 50f--
(Name of person acknowledging) (Name of person acknowledging)
(Si nature of Notary Public-State of Florida) (Sig ture of Notary Public- to of Florida)
ersonally Known V OR Produced Identification ersonally Known ✓OR Produced Identification
Type of Identificationn Produced Type of Identifica�Zp�lj
Commission No. O3L Notary Public State of Florida
., Ndts�lblic State of Florida Commission No. Susai�5 PM Costa
Susan Clark Costa a My Commission GG 032841
c M Commission GG 032841 d Expires 11/13/2020
?of�o Expires
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
COMPLETE
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