HomeMy WebLinkAboutScan_0001ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
C�t1NTY
F L 8 R i D A
Permit Number:
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 El
PROPOSED IMPROVEMENT LOCATION:
Address: 9501 Parkside DR
Legal Description: PALM BREEZES CLUB (PB 49-32) BLK 2 LOT 20 (OR 3516-2446)
Property Tax ID #: 2310-500-0062-000-5
Lot No. 20
Site Plan Name: Block No. 2
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace existing 50 gal electric water heater in garage
CONSTRUCTION INFORMATION:
A!] 11 1, ial work to Be iime un er t is permit c ec a
HVAC Gas Tank OGas Piping
DElectric LJ Plumbing OSprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
OWNER/LESSEE:
NameDavid V Sherrill
apply:
OGenerator shutters
Sq. Ft.. of First Floor: _
Utilities: l —Sewer Septic
Address: 9311 Breakers Row
City: Fort Pierce State:FL
Zip Code: 34945 Fax:
Phone No. (336) 512-4080
E -Mail
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
OWindows/Doors
ORoof a Roof pitch
Building Height:
Name:
Company: Mr. Rooter of the Treasure Coast
Address: 534 NW mercantile place. suite 119
City: Port St Lucie
Zip Code: 34986 Fax:
Phone No. 772-236-7300
E -Mail: iames.mrrooter@a gmail.com
State or County License: CFC1425604
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
State: FL
FAddress:9tii)1P.11ride
MENTAL CONSTRUCTION LIEN LAW INFORMATION:
E�R/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Sherriil Name:
-
pR Address: 9311 Breakers Row
City: For1 Pierce State: City: Part St Weis
Zip: Phone State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:_ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 5534 NW mercantile place. suite 119 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.
5t. 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 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 Commencemen
Signatu e of owner/ Lessee/Contractor as Agent for Owner Sign ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me
thislam_dayof_oc ,ten _ 20%-a by
Name of person making statement
Personally Known L�� OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State dMorida j
The forgoing instrument was acknowledged before me
this Q. dayof Zp-t _�-by
1-n
Name of person making statement
Personally Known L—` OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florid'
Commission No.PF ri C-fc� j
KR)STEN L
Notary Pubk - S
.s Cownieeion
issi No. F" Ec]7Q
t:��L1
e of Florida
FF 970405
o�� ,.' any Com+R.. zo,
s Hilar f0, 2020
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Rev. 8/2./17
-ar) 91111fitEN L BENSLI
11MY POW - State of
COel MIsslon # FF 97i
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