HomeMy WebLinkAboutBuilding Permit Application 12/15/2017 10:53 Lindquist Plumbine 7724811999 H0.282 #001
,.ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED
Date: Permit Number:
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Building Permit Application DEC 15 2017
Plunning and Develuprnent Services PERWTTli14G
Building and Code Regulation Division St. Lucie Go
2300 Virginia Avenue,Furl Pierre F134982
Phone: (772)462-1553 Fdx: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line p ]
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Address: fQQa
Legal Description: �L8 � U!Ayc4Z 1-o 7- ! ON?aCA O(2 R%3 -ff t
Property Tax ID Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Lett Side:
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Additionalworkto [JGasTank
orme under permit-c ec a appy:
HVAC ❑Gas Piping Shutters Windows/boors
DElectric Plumbing OSprinklers 0 Generator Roof Roof pitch
Total Sq. Ft of Construction: 5 Fl.of First Floor;
Cost of Construction:$ �. (� Utilities:-Sewer L I Septic Building Height:
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Name P. Name: lit/ QF.. GP�fC-
Address:___3 a Z �U!��S .� Company: LIA/I tgivrj -
City: 1,013?. State:^ Address: _3/ S SA,x o /,k,7,y
Zip Code: 3y9b�3 Fax: City: T A (� Stater
Phone No. IUO,y�9c OB D t18�� /� Zip Code: Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
12/15/2017 10:53 Lindquist Plumbing 7724611999 H0.282 #002
8-11
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DESIGN ERANGINE ER; 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:
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 additinns,
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 of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF -C'r LuCOUNTY OF A:„CU WC`
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_/f day of _ 20 /l—7by this z�day of Pt L 20 L by
(Name of person acknowledging) (Name of person acknowledging)
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(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known L-'—QR Produced identification Personally Known L�OR Produced Identification
Type of Identification Produced Type of Identification Produced.._.,_-.
Commission No. (Seal) MIC LE TRO'tTA (Seal)
VY MY CO MISSION#OG055253
91 EXPIRES December 14.2020
kevised 07/15/2014 �����
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
12/15/2017 10:53 Lindquist Plumbing
7724611999 N0.282 #003
P.1
Doc 151710:21a
Fort Pierce Utilities Authority
2.06 S 6th Street
Fort Fierce, FT, 34950
Receipt number: PYMT00005618139
Receipt Date: 12./8/2017
Customer Ib: 252230
Loca-�-ion ID: 10007399
On 3ehalf of: Re Service Address;
DCROThY E CHAPMAN
.302 SURFSXDE AVE 1406 PLATTS WT
PORT SAINT LUCIE FL 3 :963-1244 FORT 22ERCE FL 3494669ri
USA USA
Total Amount Received by Check $1,760.50