HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9�)S _ Permit Number: �� 2— C) Li�
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Building Permit Application MAR 0 9 2018
Planning and Development Services T, Lucie County, Permitting
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 4817 Christensen Rd. Fort Pierce, FL 34981
Legal Description: Christensen Acres (PB 41-12) Lot 2 (2.407 AC)(or 3423-2208)
Property Tax ID#: 3405-600-0003-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
We will chip up the kitchen drain and water lines and move them back 12", and chip a trench across
the kitchen 6' to run the new water line for the refrigerator. Next we will come back and install the new
kitchen faucet with shut-off valves and drain assembly, hook up the dishwasher and refrigerator.
FCOUSTRUCTION INFORMATION:
Additional work toe Derformed under this permit—check a appy:
HVAC El Gas Tank []Gas Piping Shutters Q Windows/Doors
11 Electric Fv—] Plumbing Sprinklers a Generator L1 Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 900.00 Utilities: 0Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Album A.Ackie Name: Chris Rogers
Address:4817 Christensen Rd. Company: Coastal Plumbing Services, Inc.
City: Fort Pierce State:FL Address: 271 SW Lakehurst Dr.
Zip Code: 34981 Fax: City: Port Saint Lucie State:FL
Phone No.(954)338-7525 Zip Code: 34983 Fax:
E-Mail: Phone No. (772)940-1144
Fill in fee simple Title Holder on next page( if different E-Mail: timnelson81@gmail.com
from the Owner listed above) State or County License: CFC#1428462
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
0310912018 16:11 JAYS FLOORS & MORE (FAX)772 335 0770 P.0011001
DESIGNER ENGINEER: oNotAMpplicableNotMORTGAGE COMPANY: Applicable
Name•AJ Wm A.Adde Nam e:chne mere
Address:4817ChrkbneenRd,FoePierc.K34931 Address: 4817ChAbsneenRd.
City: FW1 mem State: City: Port 8eln!LUA State.:
Zip: phone Zlp: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: _ Name:
Address,271 sw Laxehuret or. Address:
City: City.
ZIP: Phone Zlp: Phone
OWNER/CONTRACTOR AFFIDVIT:Application Is hereby made to obtain a permit to do the work and Installation as Indicated.
I certify that no work or Installation has commenced prior to the issuance of a permit.
St,Lucie County mak%$no representation that is granting a ppermit%li authorize the permit holder to build the subject structure
which Is in conflict with any$ppiicable Homeowners Assocfatlon 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 addldons,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residentlel 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
cornmencing work or recordlng your Notice of Commencement.
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11 n/ I(�4f1?fl A -- — c, Ww
ure of OvYnof lessee/Contractor as Agent for Owner Signature of Co ctor/License Holder
STATE OF FLORIDASTATE OF�T i COUNTY OFORID
COUNTY OF l
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The fgfgoing Instru n wa acknowledg before me The fqt gofn�instrume t wa acknowiedg��,b a
this day of 20 by this�ddaa oof 20V b
Name oferso makln statement Name of; rs mak ng statement
Personally Knownp_ 41";l OR Produced Ident Personally Known OR Produced Identl �I
Type of Identification a Type of Identification
Produced Produced
v1(d)—�'a 0�
(Signature of tary Public-State of Florida} (Signature of Notary Public-State of Florida
Commission No. os— (seal ,moi' Commission No. %X (Sea
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev,8/2/17 'TRACY CARVAL.HO
My COMMISSION O FFIDN785
EXPlft!`8 Merry 22,20N1