HomeMy WebLinkAboutBuilding Permit ApplicationSU:PPl:EMENTAL CONSTRUCTION LIEN LAW'IN FORMATION,:'
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DESIGNER/ENGINEER:_Not Applicable _Not ApplicableMORTGAGECOMPANY:
Name:Addres-s-:-------------------------------
City:State:__
Zip:Phone:_
_Not ApplicableBONDINGCOMPANY:
Name:_
Address:_
City:_
Zip:Phone:_
OWNERI 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 structurewhichisinconflictwithanyapplicableHomeOwnersAssociationrules,bylaws or and covenants that may restrict or prohibit suchstructure.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.
Name:=====_
Address:State:
C~ty:Phone ==ZIP:
FEE SIMPLE TITLE HOLDER:_Not Applicable
Name:_
Address:._
City:-:-------------
Zip:Phone:._
---
s:e~-=Signature of Contra'e
STATE OF FlORIDA.st-:~COUNTY OF .•
The forgoing instrument was acknowledged before me
this ~ay ID<..h """"-,20_r}yJ..-.:...-
nntractor as Agent for Owner
STATE OF Fl0;t--cto.....:..COUNTY OF .•
Name oTperson making sta1ement
Personally Known OR Produced Identification
Type of Identification t::i.D
Produced ~
DATE
RECEIVED
FRONT
COUNTER
ZONING
REVIEW
REVIEWS SUPERVISOR
REVIEW
DATE
COMPLETED
Rev.8/2/17
Personally Known OR Produced Identification _
Type of Identification FiD
Produced _LG
MANGROVE
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
PLANS
REVIEW
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:10/31/18 Permit Number:-----------------
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,--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:To Select from dropbox,click arrow at the end of line
,..'".'','-.,'.,"';"".~'"PROPOSE,P IMPROVEM,ENT LOCATIOI\1:"'i;,'i ,;"f -W ",'c',,"'N~w";':;,~
Address:840 se airoso blvd
Legal Description:river park unit 6 BLK 60 lot 4 (map 34/28s)(OR 3402-2074)
Property Tax ID #:3419-545-0072-000-4 Lot No._
Site Plan Name:Block No._
Project Name:_
Setbacks Front Back:Right Side:Left Side:_
DETAILED DESCRIPTIO'N Or:;WORK:-,""-..~,,.",;{l",.\"-,
ern ",,";/'.''y ie';""'1\'_,...'_""',,,"',
replacesectionof rotten4"cast iron buildingdrain with SCH 40 PVC locatedin kitchenarea to outsidesoutheastcorner
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CONSTRUCTIONINfORMATlqN:'",,'",..'b'W.:,,'~>"';".?"i''''
Ad..c!ltlonalwork to lprtormed under this permit -check all ~apply:
DHVAC _Gas Tank DGas Piping U Shutters 0Windows/DoorsDElectric1../1 Plumbing 0 Sprinklers D Generator D Roof I I Roof pitch
Total Sq.Ft of Construction:S~of First Floor:
Cost of Construction:$2,000.00 Utilities:USewer D Septic Building Height:_
,OWNER/LESSEE:'"",,"'',-".'CONTRAcTOR:'~,:-;~'",D,,,.,,",'~,'",~,
Name Ron Ades Name:David Spalding----~--~-------------------------
Address:378 SE Port St Lucie BLVD Company:The Plumbing Works Inc
City:PSL State:FL Address:_3_47_3_S_W_E_ur_o..:.,.p_e_S_t _
Zip Code:34984 Fax:City:PSL State:~
Phone No.Zip Code:34953 Fax:_
E-Mail:Phone No.772-336-7272--------------------------------
Fill in fee simple Title Holder on next page (if different E-Mail:theplumbingworksinc@gmaiLcom
from the Owner listed above)State or County License:CFC1428419 /11717
If value of construction is $2500 or more,a RECORDED Notice of Commencement is required.
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