HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: ��• � Permit Number:
RECEIVED
Building Permit Application
Planning and Development Services NOV 0 5 2018
Building and Code Regulation Division
ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential xxx
PERMIT APPLICATION FOR: Plumbing I.
PRO dSED IMP ' OUEMEIT OCA IC•�N: T.
Address: 106 SE CALMOSO DR
Legal Description: RIVER PARK-UNIT 7-BILK 66 LOT 1 (MAP 34/28S)(OR 1210/2601)
Property Tax ID#: 3419-550-0052-000-4 Lot No. 1
Site Plan Name: Block No. 66
Project Name: WATER HEATER REPLACEMENT
Setbacks Front Back: Right Side: Left Side:
17ET LED DE�5CI21PTI • N • E WOR
30 - GALLON ELECTRIC WATER HEATER REPLACEMENT
CONS;
Ems NFOR {ON:
Additionalworkto a er orme un ert is Mpernmiit–cWheck appy:
HVAC E]Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 0.00 (_ f ®,— Utilities: Sewer Septic Building Height:
OW ° ERf LEER=1 CONTRACT• R•
Name JOYCE M MASSETTI Name: RICHARD BASSOFF
Address:106 SE CALMOSO DR Company: ADMIRAL PLUMBING SERVICES INC
City: PORT ST LUCIE State: FL Address: 2895 JUPITER PARK DR#700
Zip Code: 34983 Fax: City: JUPITER State:FL
Phone No. 772-237-5541 Zip Code: 33458 Fax:
E-Mail: Phone No. 561-746-1180
Fill in fee simple Title Holder on next page(if different E-Mail: PERMITTING@THEADMIRALPLUMBER.COM
from the Owner listed above) State or County License: CFC 1426115
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
„
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:2895 JUPITER PARK DR#700 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 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 ith lender or an attorney before
comm work or recording our,Notice of Commencement
Si ure of Owner/Les ee/Co ac r as Agent for Owner Signature of Contractor/License older
STATE OFF I STATE OF FM
COUNTY OF COUNTY Oi ni-R.�C�C�n
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 26 day of OCTOBER 20 by this 26 day of OCTOBER 20 1 Y by
Name of person making statement Name of person making statement
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(S gnature of Notary ubliSi nature of Notar ublic-Stat
NICOLE M 3ULLI � NICO
VAiLE
Commission No. - ;'e MY& (a113SION#GG04312 Commission No. (6fWADNIMISSION#GG
"••,,q.�� EXPIRES October 30,2020 q!;rk � EXPIRES October 30, r, t
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17