HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMI ILETED FOR APPLICATION TO BE ACCEPTED
Date: off' Permit Number:
_I RECEIVED
uilding Permit Application MAR 0 9 2018
Pianning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 349
Phone:(772)462-1553 Fax:(772)46 -1578 Commercial Residential—
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION: _
Address: 5913 Hickory Drive Ft Pierce Flori Ja 34982
Legal Description: Like for Like 40 Gallon lectric water heater replacement
Property Tax ID#: 3402-609-0629-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WO K: j
Remove exsisting water heater an(I instal Rheem 40 Gallon electric water heater replacement
CONSTRUCTION INFORMATION
Additiona[worl to IfIrfommed undei this permit—c ec a apply: J
HVAC Gas Tank FGas Piping _Shutters Q Windows/Doors
Electric R1 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: LISewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Dorris Wagner Name:
Address: Company: First Chace Plumbing solutions
City: Fort Pierce State.FL Address: Imo"\
Zip Code: 34982 Fax: City: 9cm %- '&Py-• State:FL
Phone No. Zip Code: 34984 Fax: 772"879-7860
E-Mail: Phone No. 772-879-1414
Fill in fee simple Title Holder on next pag e(if different E-Mail: firstchoiceplumbingsolutions@gmail_com
from the Owner listed above) State or County License: CFC.ty71 3�q
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN'LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: ,Not Applicable
Name:0- Wagner
Name:
Address:5913 Hickory D'Ne Ft Fier,Fibnca 34982 Address:
City: —P%r<e 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:
OWNER/CONTRACTOR AFFIDVIT:J pplication is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has co nmenced prior to the issuance of a permit.
St.Lucie County makes no representation Mat is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Horre Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home C wners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this req sted permit,I do hereby agree that 1 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 a a 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 t>Record a Notice of Commencement may result in your paying twice for
improvements to your property.A tice of Commencement must be recorded and posted on the jobsite
before thefirst inspection. If you intend to obtain financing,consult with lender or an attorney before
commencin work or recording your Notice of Commencement.
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4
Signatur o Contractor as ent for Owner Signature o�raense Holder
STATE ORIDASTATE ,
COUNTY OFA . COUNTY OF
The forgoing instrument was acknowledge I before me The forgoing instrument was acknowledged before me
this$_day of Y ,`.r-� 20 by this day of vv-%,c ,r tx� ,20Jb by
Name of person making statemen Name of person making statement
Personally Known_t_Y_�OR Produced Ic entification Personally Known i5e,^OR Produced Identification
Type of Identification Type of Identification
Produ ed Produced
(Signature of Nota Public- ate of Florid ) (Signature of Notary Public-State o Florida)
y t Anana Veneziay Aruna Veneziano
Commission N NOTARYPUB4 al) Commission No YPUBU�Seal)
WArEOF FLOR A
DCOnyrg
STATE OF FLORIDA
Comrr GGt859i GGISS9ta
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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