HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED nn',� Q I
Date: , Permit Number: V I 1^ 3 to
RECEIVED
•
111 a.19
Building Permit Application SEP 14 2017
Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing El
PROPOSED IMPROVEMENT LOCATION:
Address: 7414 1 f akeS Tc. ?act So
Legal Description: Reserve Plantation-Phase IIA-Lot 54
Property Tax ID#: 3321-803-0058-000-1 Lot No.54
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Update master bathroom with customer supplied tub, valves and install a new shower pan.
CONSTRUCTION INFORMATION:
Additional work to be nerformed under t ispermit—c ec a appy:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing []Sprinklers 11 Generator F] Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1,200.00 UtilitiesliSewer Septic Building Height:
OWNER/LESSE'E: CONTRACTOR
Name Qpal4(,( Q-FA 1l _ec\, A 47� Name: (2TF'eg PZ.&g-_55�P_M
Address: 799 l [4,.kx, 1 la-k-6.5 Pr-• Company: Welworth Plumbing LLC
City: ?AO ' SLLi '� L ou� l State:Fl_ Address: 1616 6747Mcs
Zip Code: 34986 Fax: City: 4d!'-L :2w e F`z_ State:FI
Phone No.760-413-6441 Zip Code: 34982 Fax:
E-Mail: /a Phone No. 772-579-2462
Fill in fee simple Title Holder on next page(if different E-Mail: wellworthplumbingllc@aol.com
from the Owner listed above) State or County License: CFC1428815
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LI
EN LAUV INFORMATION
DESIGNER/ENGINEER: x 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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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.
---
Signature Owner/Lessee/Contractor as Agent for Owner Signikiture.of ntractor/License Holder
STATE OF FLOR A STATE OF FLORIDA �Ct ,
COUNTY OF COUNTY OF
The fo oing instr ment as acknowlecigQd.before me The forgoing instr ment a cknowledged before me
this W day of 20 r��l by this�day of 20 by
00eon eA
Na a of pe son making statement N me ot person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identif- tion Type of Iden ' 'cation
Produced Produced
1
1
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
KAREN
,.�;`;��•�;. ($e�1tjIELSEN Commission No. """"��• KARE , a IELSEN
Commission No. .•.
_� *c mmission# FF 115637 ^� Commission k FF 115637
�•��� `�? My Commission Expires My Commission Expires
••,,,;,� June 12, 2 01 8 ,��•
"i1j,a
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17