HomeMy WebLinkAboutBuilding Permit Application Jan 2618, 10:04a Jensen Beach Plumbing 7722256779 p.1
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TOBE ACCEPTED
Date: Permit Number: Ou
Building Permit Application RECEIVED
Planning and Development Services
Building and Code Regulation Division JAN'2 6 2010
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential x Permitting Department
St. Lucie C
PERMIT APPLICATION FOR: Plumbing El
PROPOSED IMPROVEMENT LOCATION: ..
Address: 104 Nettles Blvd
Legal Description: Nettles Island Inc a condo-section 11 parcel 104 and pro-rata share in common elements
Property Tax ID#:4502-501-0290-000.0 Lot No.104
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILEP'DESCRIPT10N OF WORK:
Install 40 gal tal electric water heater in garage
CONSTRUCTION INFORMATION: .
Additional work to be performed under this permit-c ec all tLat appy:
❑HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors
❑Electric 0 Plumbing [:]Sprinklers ❑Generator ❑Roof Roof pitch
Total Sq.Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1000.00 UtilitiesSewer❑Septic Building Height:
'OWNER/LESSEE: CONTRACTOR:
Name Pamela&James Correll Name: Lonnie Culbertson
Address:35956 Quakertown Ln Company:Jensen Beach Plumbing,Inc
City: Farmingtn Hills State:MI Address: 1086 NE Industrial Blvd
Zip Code:46331 Fax: City: Jensen Beach State:FL
Phone No.772-229-6558 Zip Code:34957 Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: mariah-jbplumbing@bellsouth.net
from the Owner listed above) State or County License: RF11067372
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Jan 2618,10:05a Jensen Beach Plumbing 7722256779 p•2
ONSTRUCT SUP ON
1 LIEN.LAW INFORMATION:
.LEMENTAL.0
DESIGNER/ENGINEER: ^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:1098 Ne Indasarai Bid 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.
1 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 t will,in all respects,perform the work
in accordance with the approved pians,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 pasted an 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.
ature of Own see/Contractor as Agent for Owner ' nature of Contractor/License der
STATE OF COUNTY OF FLORIDA STATE ICRC�—A STATE OF FLORt�� , 1`�+
i'� COUNTY OF
The for tin instrument was knawled fid,before me The ring instru ent was acknowledged before me
thi�day ofAt.)1.1 ,241 by thi�"d'ay of 'rk`���26JEL by
Name of per n making statement Name of pers making statement
Personally Known OR Produced Identification Personally Known V OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
i COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8(2/17