HomeMy WebLinkAboutBuilding Permit Application OG/19/2018 09:44 Lindquist Plumbina 7724611999 N0.642 #002
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J '0 ,
Date: '�'� Permit Num AM
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Building Permit Applicatio
JUN 2 0 2018
Planning and Development Services Permitting Department
auilding and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential )22( XX
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: I�
Legal Description: NORTH FORK ESTATES SID LOT 21 (0.59 AC;)(OR 154,1-1702:2669-690)
Property Tax ID#: 3409-503-0024'•000-2 4ot No.
Site Plan Name: Block No-
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Install New Water Heater
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Additional work to MGas
orme un ert is permit—c et a appy:HVAC Tank Das Piping —Shutters Windows/Doors
Electric 0 Plumbing ' r7Spr1nklers ' • ElGenerator Roof Roof pitch
Total Sq.Ft of Construction: Ft. of First Floor:
Cost of Construction:$ 1•,000.00 Utilities; Sewer[]Septic Building Height:
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Name (1Q lam' Name:_W0 -"f'
Address: I/ OLE— Company: LINDQUIST PLUMBING COMPANY
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City: it ' State:FL' Address: :33 �' 1(!eC.[ 'I
Zip Code: 34982 Fax: City_ FOVT L e State.PL
Phone No-772-370-6755 Zip Code: 34945 Fax: 772-461-1999
I E-Mail:_ ,.. _ Phone No.---772-461-1969
Fill in fee simple Title Holder on next page(if different E-Mail: Lindquistplumbingcompany@gmail_com
from the Owner listed above). State or County License: CFC 1428458 W
If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required.
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06/19/2016 09:44 Lindquist Plumbing 7724611999 N0.642 #003
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: F 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: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 biome 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
commencinp,work or recordingyour Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 3T LUCIF. COU NTY OF ST LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 19TH flay or JUNE 201 Eby this 1J1H day of JUNE 20 11C by
0,6e- pt,s e-. UN)ckcf e. a s� .-,--
Name of person making statement Name of person making statement
Personally Known xxxx OR Produced Identification Personally Known xxxx OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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(Sign tur of Notary Pubs ? T: i� FSS& �t1tpyj Signa ure of Notary Publi 1 two W' I0N9GG111078
Commission No. ccrr107a 1 ,f �p pa ommission'No. GG I10r6 k;o'rNq°Af p mbw 27. EXPIRES:December 2 e
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REVIEWS FRONT ZONING SUPERVISOR PLAN5 VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE -
COMPLETED _
Rev-8/2/17