HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11 /14/18
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Ford Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: plumbing
PROPOSED IMPROVEMENT LOCATION:_
Address: 5717 Sunset Blvd. Fort Pierce. FL 34982
Legal Description: INDIAN RIVER ESTATES -UNIT -08- BLK 64 LOT 31 (MAP 34/11 NANDS)
(OR -296.2-279'3382-2668. 3830-631)
Property Tax 1D #: 3402-609-0469-000-7 Lot No. 31
Site Pian Name: Block No. 64
Project Name:
Setbacks Front Back: Right Side: Left Side:
I DETAILED DESCRIPTION OF WORK: I
Remove and replace 50 Gallon Electric Water Heater located in the laundry room
(interior of home).
CONSTRUCTION INFORMATION:
itdTionalworW'to e e Orme un- ertfiispermit—r c�ieckair app v-
0HVAC f Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
11 Electric WIPlumbing El Sprinklers FIGenerator F] Roof Roof pitch
Total Sq. Ft of Construction: 1,360 Sq. Ft. of First Floor: 1.360
Cost of Construction: $ 767.00 Utilities:Sewer aSeptic Building Height! 1 Story
OWNERAESSEE:
CONTRACTOR:
Name Frik WiIP
..........
Name: Adgm 1amn.nn
Address: 5717 Sunset Blvd
Company: Southoaw Piumbina & Meterina Svc. LL
City: Fort Pierce State: FL
Zip Code: 34982 Fax: N/A
Phone No. 772-519-2009
Address: 1458 SW Bartell Ave
City: Port St. Lucie State: FL
Zip Code: 34953 Fax: 772-324-6531
Phone No. 772-486-0914
E -Mail: N/A
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: adam@?Southr)awwater.com
State or County License: CFC1428285/29207
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:_
Address:
City: —
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
State
— Not Applicable
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 with lender or an attorney before
commencing work or ecdrdin our Notice of Commencement.
Rev. 8/2/17
Sign to of Owner/ Le /Contract r as Agent for Owner
III
gnature of Contracto is nse Hold4r
,
STATE OF FLORIDA II
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STATE OF FLORIDA a ��
COUNTY OF `T
COUNTY OF l�L
The forgoing instrument was acknowledge before me
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I The f going instrument was acknowledged before me
day N QVCM �W 20 IK by
this \0 day of 1U )J VY1 b 4_20 by
this of
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Name of pe making statement
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Name of personmaking statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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{ gna re of Notary Public- fie 4rPA r issi.XFFW1672
(Sig t e of Notary Public- State f io a':i't CommissionXFF 61612
Excites February 17, 2020
e Ex ires Fetrua 11, 2020
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Commission No.` ' f �? tsdidJnruTroyFainInsurance800.
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REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
— --
DATE -
�--
RECEIVED
DATE
[COMPLETED__
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Rev. 8/2/17