HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3I 6 Permit Number: 1A 03'(3,a$
RECEIVED
SIM
Building Permit Applicatiolp MAR 0 6 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County P�rrtlltting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 5704 TRAVELERS WAY
Legal Description. PALM GROVE S/D BLK B LOT 15
Property Tax ID#. 3410-503-0060-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
EXACT WH CHANGE OUT 50 GAL ELEC
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
HVAC 11 Gas Tank E]Gas Piping _Shutters Q Windows/Doors
11 Electric ❑✓ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq• Ft of First Floor:
Cost of Construction: $ 550 Utilities: Sewer El Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name JOSEPH &RAQUEL CONSTANTINE Name: ALLEN STEINMAN
Address:5704 TRAVELERS WAY Company: SERVICE AMERICA ENTERPRISE INC
City: FORT PIERCE State:FL Address: 2755 NW 63 CT
Zip Code: 34982 Fax: City: FT. LAUDERDALE State:FL
Phone No.772-461-2325 Zip Code: 33309 Fax:
E-Mail:cons520@att.net Phone No. 954-979-1100 X 5673
Fill in fee simple Title Holder on next page(if different E-Mail: EPERMITSGROUP@SERVICEAMERICA.COM
from the Owner listed above) State or County License: CFC057026
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: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:2 �`^'�" 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,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—o ner lessee/Contractor as Agent for Owner Signature ntractot
License Holder
STATE OF FLOPADA
�,^,�,^� STATE OF FLO DA
COUNTY OF DrOCOUNTY OF rf) Ord
The forgoing instrent was acknowledged before me The forgoing instrument was acknowledged before me
this aday of garch 20['� by this a day of HQfYh 201_e by
�1\CA S %'Ayr\a✓i Nile-11"\
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 Identification
Produced Produced
r
(Signature of N Stategj��gidgfiries (Signature o o I+10t 0WtF$tfiid0f)Florida
Notary Public-State/ of Florida �� Commission#GG 70668
Commission N ( Commissio� �
g70668 Commissio v, a 'rest/7/2o(NeaI)
'TFOFF�o —Expires 2/7/2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17