HomeMy WebLinkAboutKillarney permit. I) ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE
Date: 8/1/2018 Permit Number:
I(
II •
Building Permit Application
Pionnina and Develooment Services �!
I� Building and Code Regulation Division II
2300`'Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
III PERMIT APPLICATION For-: To Select from drophox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION: '-T�i Neon oF ,*P-
Address: 5814 Killarney Ave. Fort Pierce
�I ark
Legal Description: Lakewood p
Property Tax ID#: 130161300310005 Lot No.31
Site Plan Name: Block No. 137
Project Name: Killarney Ave
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
New 40 gallon water heater connection. Electric. Remove old and install a new one.
CONSTRUCTION INFORMATION:
Additional work to e er orme m
under this perit—c ec a app y:
❑HVAC E] Gas Tank ❑Gas Piping _Shutters Windows/Doors
1-1 Electric R1 Plumbing Sprinklers El Generator Roof �— Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 650.00 Utilities: Sewer D Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name RMZL Capitol Name: Abner Leyva
Address:2740 SW Martin Downs Blvd. #4 i 1 Company: Leyva plumbing
City: Palm City State:FL Address: 1502 SW Meridian Ave
Zip Code: 34990 Fax: City: Port St. Lucie State:FL
Phone No.772-418-4812 Zip Code: 34953 Fax:
E-Mail:rick@ginnagency.com Phone No. 786-586-6928
Fill in fee simple Title Holder on next page ( if different E-Mail: leyvaplumbing@yahoo.com
from the Owner listed above) State or County License: CFC 1425666
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address:----- T__,,. Address: t�aTE=
City: 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: 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 Assoc ion 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 your Notice of Commencement.
Signa of Ow Lessee/Contractor as Agent for Owner Sig atu of 6o,
r ctor/License Holder
STATE OF FLORIDA I 1 'l STATE OF FLORIDA i f
COUNTY OF y�' � �1 C 11.J _ COUNTY OF 7 T` �M U e— cc ur""
The forgoing inst ant was acknowledgedbefore me The forgoing instrument was acknowledge before me
ru
this \ day of U" 20 by this L day of 201 i� by
Name of pe�onpaaking statement Name of persopmaking statement
Personally Known ✓ OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary I (Sig aturerlg'i3b
�a►W Notary Public State of Florida .► �' Notary Public State of Florida
Commission No. Javier Sogtila Commissio Javier Santana (Seal)
tea—My Com fission GG 239744 �� y ommission GG 239744
ofaC Expires 07/18/2022 Of Expires 07/18/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17