HomeMy WebLinkAbout9304 Wentworth Lane St L CoALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: November 14, 2017 Permit Number:
J -
4111
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
PROPO ED IMPROVEMENT LOCATION:
Address: 9304 Wentworth Lane
Legal Description: POD 20A at the reserve PUD!I Castle Pines Lot 69 (map 33/27S) (or 3734-167
Property Tax ID #: 3327-801-0077-000-2 Lot No.
Site Plan Name: Block No.
Project Name: Anderson
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace 40 gal elec water heater
CONSTRUCTION INFORMATION:
AOditional work toa pertormed under this permit — check a y: app
HVAC Gas Tank []Gas Piping _ Shutters ❑ Windows/Doors
0 Electric 0 Plumbing Sprinklers E] Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 795 Utilities:n Sewer E]Septic Building Height:
OWNER/LESSE ,_„_
ONTRACTOR:
Name: Anthony Agrusa
Name Marc Anderson
Address: 9304 Wentworth Lane
Company: North County Plumbing
City: Port st. Lucie State: FI
Address: 2647 President Barack Obama Highway
City: Riviera Beach State: FI
Zip Code: 34986 Fax:
Phone No. 561-625-8717
Zip Code: 33404-4114 Fax: 561-625-8717
E-Mail:
Phone No. 561-625-9414
Fill in fee simple Title Holder on next page ( if different
E-Mail: Northcountyplumbing@hotmail.com
State or County License: CFCO26530
from the Owner listed above)
If value of construction Is $2500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 anr�ey before
commencins �v
work or record in of Commencement. /�
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUOF
Th f i instr t led66l efore me
this day of 201Tby
(Name of person ack owle ging)
r
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identificatio Produced .�v Pte. V��k
Commission No.
Revised 07/15/2014
STATE OF FLORIDA
COUNTY OF Pal amort
The ins instr edge fore me
methis 1�-2 y of 20 H by
Anthony Agrusa
(Name of perso acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known / OR Produced Identification
Type of Identification Produced
Commission No.
(MCa IESRACLARKE
ISSION
EXPIRES: Januarv23.201
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
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DATE
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INITIALS