HomeMy WebLinkAboutBuilding Permit ApplicationALL 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, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing
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Address: 55 HUARTE WAY
Legal Description: ST LUCIE GARDESN
Property Tax I D #: 3414-501-1701-000-9
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
REPLACEMENT OF 50 GALLON HEATER WITH PERMIT
Lot No.
Block No.
iaitionai worK to de ertormea unaer tnis permit — cnecK an tm apply:
HVAC _ Gas Tank DGas Piping _ Shutters 11 Windows/Doors
Electric ✓❑ Plumbing OSprinklers ElGenerator ❑ Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 1,195.00
S . Ft. of First Floor:
Utilities: _ Sewer ElSeptic
Name GAYLE TIBER
Address: 55 HUARTE WAY
City: PORT ST LUCIE State: FL
Zip Code: 34952 Fax:
Phone No. 347-831-5457
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: RICHARD BASSOFF
Building Height:
Company: ADMIRAL PLUMBING SERVICES, LLC
Address: 2895 JUPITER PARK DR #700
City: JUPITER State. FL
Zip Code: 33458 Fax:
Phone No. 561 746-1180
E -Mail: christine@theadmiralplumber.com
State or County License: CFC 1426115
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name:
Address:
City: State-
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
.MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State-
Zip: Phone:
BONDING COMPANY: Not Applicable
.Name:
Address:
;City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the ' �section,. if you intend to obtain financing, consult w th lender or an attorney before
commen n�rdine vour Notice of Commencement.
J
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF PALm eam
The fo Ing instru ent was acknowledged fare me
P-3day of ►n 20 �$�by
(Name of person acknowledging)
of Notary
anally Known
of Identification
Commission No.
Revised 07/15/2014
State of Florida )
OR Produced Identification
Notary PUNC stm of 1,101W
a` MY ata 032841
Expires 11/1312020
STATE OF MORIDA
COUNTY OF PALMM=H
The forgoing instru ent was acknowledged b fore me
6ls��day of TCt *-u-�n . 20 1 Yby
(Name of persoli acknowledging)
at a of Notary Public- State of Florida)
orally Known �/ OR Produced Identification
of Identification Produced_
Commission No. 0 Susdn' fic141 SC a FbrWa
My Cofomtaabn as 032841
Exofts 1111312020
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DATE
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