HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 5745 Spanish River Rd
Legal Description: Portofino Shores
Property Tax ID #: 1312-503-0087-000-8
Site Plan Name:
Project Name: Water heater Installation
Setbacks Front Back: _
DETAILED DESCRIPTION OF WORK:
IIInstallation 50 gallon electric water heater
Right Side: Left Side:
Lot No. 291
Block No.
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit - ch-e-cT< all that appy:
❑HVAC Gas Tank F]Gas Piping _ Shutters ❑ Windows/Doors
❑ Electric ❑✓ Plumbing ❑ Sprinklers ❑ Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S�Ft.j of First Floor:
Cost of Construction: $ 995.00 Utilities: LJ Sewer ❑ Septic Building Height:
OWN ER/LESSEE: _
Name Robert Ramsey
CONTRACTOR:
Name: James Marsala
Company: Peerless Plumbing & Drain Services
Address: 5745 Spanish River Rd
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No.
Address: 651 NW Enterprise Dr Unit 106
City: Port Saint Lucie State: FL
Zip Code: 34986 Fax: 772-344-6360
Phone No. 772-223-1356
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: fames@peerlessplumbing.net
State or County License: CFC 1428692
-
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requires.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.
Not Applicable MORTGAGE COMPANY: — Not Applicable
DESIGNER/ENGINEER:
_
Name; James Marsala
Name: Robert Ramsey
Address: 5745 Spanish River Rd
Address: 5745 Spanish River Rd
State: City: Port Saint Lucie State:
City: Fort Pierce
Cit
Phone:
Zip: p'
Zip:
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FEE SIMPLE TITLE HOLDER:
— Not App Ilcable BONDING COMPANY: _Not Applicable
Name: ame:
Address: 651 NW Enterprise Dr Unit 106
Address:
City:
City:
Zip' Phone:
Zip: Phone:
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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 your Notice of Commencement.
of Owner/ Lessee/Contractor as Agent for Owner Signatur Contractor/License Holder
STATE OF FLORI STATE OF FLORIDA
COUNTY OF 7T L n ,_J0 COUNTY OF SA -
The forgoing instrument was acknowledged before me
this _a_ day of 20_0 by
Name of perso aking statement
Personally Known - OR Produced Identification
Type of Identification
Prodktced n
re of Nota
Commission No.
REVIEWSI FRONT I ZONING
COUNTER REVIEW
The forging instrument was acknowledged before me
this Q1 day of 20157 --by
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Name of peaking statement
rson
Personally Known OR Produced Identification
Type of Identification
"A MCtiH E
ly, uiic - State f�
scion # FF 9539';
m. Expires Se 18.
-Vof Notary Public- Stale,
ion No. -�F X31 60
RACHEL A HqU
Notary Publicl`
Stag Florld
Commission # 12�1005
My Comm. ExpiresuF, 201
SUPERVIS
GETATIATURTANRO
REVIEWOR I REVIEW PLANS I V REVIEWON ISE EV EWLE I MRVGEWVE
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17 -; �i '; 10
DANA MCGHEE
Notary Public - State of Florida
Ni Commission # FF 995393