HomeMy WebLinkAboutBuidling Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number_
•
EM
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
PROPOSED IMPROVEMENT LOCATION:
Address: 9611 Enclave Place Port St Lucie, FL 34986
Legal Description: Like for like
Property Tax ID ##: 3322-800-0021-000-7
Site Plan Name.
Project Name:
Setbacks Front Back:
Right Side
I Remove and install new 50 gallon electric water heater..
Left Side:
Lot No._
Block No.
CONSTRUCTION INFORMATION: V I
Additional worK to t)e pertormed under this permit—cnecKall tligit apply:
HVAC L �.I Gas Tank DGas Piping _ Shutters
Electric 0 Plumbing OSprinklers Q Generator
Total Sq. Ft of Construction:
Cost of Construction: $ <i� .
S Ft. of First Floor: _
Utilities:'n Sewer ❑ Septic
Windows/Doors
Roof Roof pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name George Henderson Jr
Name: Manuel Duran
Address: 9611 Enclave Place
Company: First Choice Plumbing Solutions LLC
City=. Port Saint Lucie State: FL
Zip Code: 34986 Fax:
Phone No.
Address: 1687 SW South Macedo Blvd
City: Part Saint Lucie State: FL
Zip Code: 34984 Fax:
Phone No. 772-879-1414
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: firstchoiceplumbingsolutions@gmail.com
State or County License: CFC1427369
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:1687 SW SoUth Macado Blvd
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencemenmust be recorded and posted on the jobsite
before the f . n. If you intend to obtain financing, nsul 1with le e_r..or laefare
commen�on ork or recordine vour Notice of Commencement.` N
Signature of O,rn$r/ Le`bseeLContracto� as Agent for Owner
STATE OF FLORIDA _
COUNTY OF���,�e _ -.�
The forgoing instrument was acknowledged before me
this --*day of 20 `, by
Name of person making statement
Personally Known OR Produced Identification
Tvne of Identification
(Signature of N
Commission No.
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
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c- Statelof Florida )
Signature o Contr'rAicense P odder
STATE OF ORI A
COUNTY OF A A
The forgoing instrument was acknowledged before me
this `lay of A`i ''u>. �._v -4� t 20� by
Name of person making statement
Personally Known ZZ,� OR Produced Identification
Type of Identification
Produ ed
i
ntIA,,,►�,�. inn ��
ignature of Notary Public- State of Florida )
A rIwano Commission No.
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STATE
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STATE OF FLORIDA
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Expires 2/1#/2022
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