HomeMy WebLinkAbout5514 Bucahnon plumbing appALL 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, Fart Fierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:{ ,:',rJ
Property Tax ID#:
Site Plan Name: Lot No.
Project Name: Block No.
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
11 4
CONSTRUCTION INFORMATION:
it�ona wor<to e erarme un ert ispermit—c ec
LIa tappy:
HVAC Gas Tank ❑Gas Piping _ Shutters
OElectric ® Plumbing Sprinklers O Generator
Total Sq. Ft of Construction:
Cost of Construction: $ ;
SFt. of First Floor: _
Utilities:cnSewer Oseptic
OWNER/LESSEE: -
Name �'' ?3i
Address: � 1`
City: V ; - State x
Zip Code.v ;F a
Fax:
Phone No. _ e
E -Mail
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: JOSEPH TULLY
OWindows/Doors
E] Roof Roof pitch
Building Height:
Company: GENESIS PLUMBING SERVICE INC
Address: 1532 SE VILLAGE GREEN DRIVE UNIT B
City: PORT ST LUCIE State: FL
Zip Code: 34952 Fax: 772-335-2680
Phone No. 772-337-3682
E -Mail: GENESIS PLUMBINGSERVICES@GMAIL.COM
State or County License. CFC1429103
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION -
DE
SIGNERANGINEER: Not Applicable
dame: MORTGAGE COMPANY: Not Applicable
Address: Name: -"
City. Address:
State: City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: BONDING COMPANY: ,Not Applicable
Address: Name:
City: Address:
Zip: Phone: City:
ZiP: - Phone:
I certify that no work or installation has commenced prior to the issuance of a permit,
makes no
which is inoconfli t with any applicableion HomeaOiwners Association ranting a permit will
or and the covenants thto att may rthe estriciborp prohibit structure
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 recordin our Notice of Commencement.
mature of Own er,I seejContractor as Agent for -Owner of Contras�r/lnc i `- _
STATE OF FLORIDA,-,, , STATE OF FLORIDA �.,
COUNTY OF ` COUNTY OF
TheVday
ing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this of20 Mby this da of _ ;
y I; a°.,1; 20 by
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(�ignatU e ot Notary Publit- State of Florida }
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Type of Identificati t Commission # GG 97150
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Commission NO.
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Revised 07115/2014
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REVIEWS ZONINGFRONT SUPERVISOR
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INITIALS
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REVIEW REVIEW REVIEW