HomeMy WebLinkAboutBuilding Permit Application 04/30/2018 MON 12: 43 FAX 561 625 8717 North County Plumbing 0001/003
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:l
.WARIP- .'
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: S'30
Legal Description: Holiday Pines SID-PHASE II B-Lot 268(Mapl3/12S)
Property Tax ID#: 1312-801-0071-000-8 Lot No.
Site Plan Name: Block No.
Project Name: Aong W/H Replacement
Setbacks Front Back: Right Side: Left Side:
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Replace 40 Gal electric water heater in same location.
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itiona wor to a er orme un er t is perms —c ec a appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing �5prinklers Generator F]Roof Roof pitch
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 795.00 Utilities:0 Sewer O Septic Building Height:
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Name chuanyuYang Name: Anthony Agrusa i
Address:5309 Eagle Drive Company: North County Plumbing
City: Fort Pierece State:FL Address: 2647 President Barak Obama Hwy
Zip Code: 34951 Fax: City: Riviera Beach State:FL
Phone No.772-999-1434 Zip Code: 33404 Fax: 561-625-8717
E-Mail: Phone No. 561-625-9414
Fill in fee simple Title Holder on next page(if different E-Mail: northcountypiumbing@hotmail.com
from the Owner listed above) State or County License: CFCO26530
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value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
04/30/2018 MON 12: 44 FAX 561 625 8717 North County Plumbing 2002/003
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: Not Applicable
Name:Chuanyu Yang -
N a m e:Anthony Agrusa
Address: Address: 5309 Eagle Drive
City: Fort Plerece State: City: Riviera Beach State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: —Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address:2647 President Barak Obanna H" 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 Count 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 yo tend to obtain financing, consult with lender or ttorney before
cornmencing work or recor ' ur Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORI STATE.OF FLOF��1�,,,,, b&4
COUNTY OF COUNTY OF r',1/!��
The forgoing instr ent as acknowledged before me The f oing instr ent w s acknowledged before me
this day of 20 by thi day of r 20� by
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Nam f per making statement Named perso making statement
Personally Known OR Produced Identification Personally Known A:�' OR Produced Identification
Type of Identificati Type of Identification
Produced Produced
(Signature of Not u��• Y ,ot Fon HNSON (Signalure of Nota „
Wary u lie-State of Florida �,aY PG6,, L NIE J6}iNSON
Comi�� n#FF 197676 ?r°, C . Notary Pr�h lhl�State of Florida
Commission No. :N* +r, Commission No. _ ad
,'FOF f`oP, My Co m.Expires Apr 20,2019 - Comrdls,on#FF 197676
Bonded through National Notary Assn. � � o-pO My Comm.Expires Apr 20,2019
" Bonded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17