HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ►�''(
Date: 11/29/17 Permit Number: ' 1 1 t I/+�Uo
Building Permit Application DEC 0 1 2017
Planning and Development Services R
Building and Code Regulation Division Lucie iIT unty,
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL
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: 8328 Muirfield way
Legal Description: POD 27 AT THE RESERVE MUIRFIELD REPLAT LOT 40(OR 3395-677)
Property Tax ID#: 3328-802-0043-000-1 Lot No.LOT 40
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace original pool gas heater. Like for Like
payliNi Zzc
CONSTRUCTION INFORMATION:
Additional work to (ever orme under this permit—check a appy:
❑HVAC LJ Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction: $ (' Utilities: Sewer Sewer Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Mike Samules Name: Erik Showen
Address:8328 Muirfield way Company: All About Pool Management
City: Port Saint Lucie State:FL Address: 10519 sw west park ave
Zip Code: 34987 Fax: City: Port saint Lucie State:fl
Phone No.16102127229 Zip Code: 34987 Fax:—
E-Mail: Phone No. 4077602373
Fill in fee simple Title Holder on next page( if different E-Mail: Erikallen2479gmail.com
from the Owner listed above) State or County License: CPC 1458545
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Mike Samuies Name:Erik Showen
Address:832eMuirtieid way Address: 8328Muirtieidway
City: Port Saint Lucie State: City: Port saint Lucie State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:10519 sw west park ave 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,wails,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of CommenceAredand
ult in your paying twice for
improvementsW'nst
roperty. A Notice of Commencement musposted on the jobsite
before the firstn. If you intend to obtain financing, consur or an attorney before
commencin wordin our Notice of Commencement.
X), J__X A
Signature n r/L7esseEVcontractor as Agent for Owner -SiKaple of Contractor/Lice se Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �S • t uci E COUNTY OF L
The forgoing instr ent was acknowledged efore me The forgoing instr ent was acknowledged before me
this day of 20by this__F_day of 20A by
Name of person making statement Name of person making statement /
Personally Known OR Produced Identification_� Personally Known OR Produced Identification
Type of Identification Type of lclentifWion
Produced Produced f0 A10
t i
cs----
( lic-S odds I �_ (Signature of Nota yPublic-State of Florida
Signature of Nota Pub
)
KAREN S NIELSE N
Commission No. ,niss;oAWO 115637 Commission No.JUL al
P My Commission Expires KAREN
°.' S.
June 12, 2018 commission pNIELSEN
r r:op,prarlisslo
Expires
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATI ne 1 }A ROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17