HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/14/18 Permit Number: j i �� ss-if
COUNTY
,F L U. .R 1 D ,A • -
WEIWRIFORP 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 ''
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 1709 Coranado Ave
Legal Description:
Property Tax ID it 2421-512-0030-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Gas tankless water heater changout.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all apply:
HVAC _Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric 0✓ Plumbing _Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ 500.00 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Ethel M. Kng Name: Chris Johnson
Address: 1245 Carlton Ct.Apt. 202 Company: CNJ Plumbing LLC
City: Ft.Pierce State:FL Address: 1701 S37th St
Zip Code: 34949 Fax: City: Ft. Pierce State:FL
Phone No.772-528-8080 Zip Code: 34947 Fax:
E-Mail: Phone No. 772-801-3073
Fill in fee simple Title Holder on next page (if different E-Mail: chrisjohnson@fpua.com
from the Owner listed above) State or County License: 30950
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State: h
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: I Name:
Address:1701 S37thSt Address:
City: I City:
Zip: Phone: I 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 permitsu
holder to build thesubject 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 recordin: our Notice of Commencement.
Signature o er/Lessee/Contract s Agent for Owner a ure of Contractor/Lice se Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Sv" LlA C1 Q COUNTY OF S\-- (,Ll C l -32--
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 9`I day of I J OV _ ,20 IS' by this /L-1 day of /')CSV - , 20 I e by
C60'5 7o hnsk9A-2 Chi, 5 SLDhv-‘s
Name of person making statementL Dl.. Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification✓
Type of Identification Type of Identification
Produced FL u L. Produced FL Ok---
ELLEN VAUCI IN.. ""' i
.�,arv�e., ,w.s:, ELL V�U(3H )
(Signature - �PtbliM StRermfiaFtbniaizy Public (sit piaa0lbPH df¢ � der -
_* '' * Commission # GG 270079 =''y ' *= Commission # GG 270079
.'F1',e My Commission. s =VII IIo My Commission Expires
Commissio C3„47°. October 22, 2 'g` Cor�rrfv q No. October 22, 2022 Seal)
_ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17