HomeMy WebLinkAboutBuilding Permit Application NOV-26-2018 14:41 FROM:ACE PLUMBING, INC 7725678494 TO:17724621578 P.2'3
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/26/2018 Permit Number: 1'3'1 1 0/6 q
1 AMMEMMEMEMEMb
COUNTY ,
UMMEMMEMNEMMO 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 XXX
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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::'01006'015'IMPRb(EIAENT LOCATEON "' •
Address: 5629 Spanish River Road, Fort Pierce, Fl 34951
Legal Description; Portofino Shores Phase Three(PB 43-40), Lot 224
Property Tax ID U: 1312-503-0030-000-4 Lot No.224
Site Plan Name: .. Block No.
Project Name:,
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION QF WORK:
Furnish and install new 50 gallon electric hot water heater
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CONSTRUCTION INFORMATION:. ••• •
r •itiona wor to • e Orme. un•er s perm t—c ec a i�FI app y;
El HVAC a Gas Tank Das Piping 1 Shutters Q Windows/Doors
❑Electric El Plumbing lSprinklers 11 Generator ❑Roof Roof pitch
Total Sq.Ft of Construction: „ S .Ft.of First Floor:
Cost of Construction:$ $1,000.00 Utilities;Ll OSeptic Building Height:
'OWNER/LESSEE: .v..>:: .:. :...... '•• ••:"'"'''''' CM"NTRACTOR; .. . .
Name James Wood Name: Danis Washburn
Address: 5629 Spanish River Road Company: Ace Plumbing. Inc,
City: Fort Piece State:Fl Address: 665 4th Place
Zip Code: 34951 Fax: .. City: Vero Beach State:Fl
Phone No.1-804-310-5208' Zip Code: 32962 Fax: 772-56748494
E-Mail: Phone No, 772.562.3780
Fill in fee simple Title Holder on next page(if different E-Mail: aCe-plumbing@comcastnet -
from the Owner listed above) State or County License: 20940-CFC032636
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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NOV-26-2818 14:41 FROM:ACE PLUMBING, INC 7725678494 TO:17724621578 P.3'3
•SUPPLEMENTAL CONSTR JCTI(N LIEN'LAW IN'FOR`MATION: • • • • •
1 DESIGNER/ENGINEER: w Not Applicable MORTGAGE COMPANY: —Not Applicable
Name; „ _ Name:
Address: Address:
City: . .State: City: _ State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable mBONDING COMPANY: ,,,,,,,,Not Applicable
Name: Name: _ __ _ _ y
Address 84tPIc^ _ 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 with lender or an attorney before
com encing work •r recordingyour Notice of Commencement.
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: / ' . .%-"‘A-2-1 ,-
Signature
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Signature o Owner/Lessee/Contractor as Agent for Owner Sig ture of ontractor/Ucense Holder
STATE OF FL R1 STATE OF FL ID
COUNTY OF� \Ckc) )'cx .- COUNTY OF \1r\ .Q n 1Lrs
The fgrgoing instr ent was cknowledg before me The rgoing inscr ment wa acknowledg before me
this day of�Q �20 thi�day of f L 1 ,Z0 by i
Name of person making statement 1 K 15 ry t` ' Name of peoon making statement = .
Personally Known OR Produced Identirt 11 ° I Personally Known .,J\ OR Produced identific:�i. ?>G
Type of Identification I i Type of Identification t 1
Produced i {a• I Produced ; '
1 ) 2 i-1
Cs--)., _ t ,.,,......
$ NotaryFlorida) $ ) ( g azure o otary u c-State of Fli----170a }Lr ��f�
(Sin ure of Nota Public-State of Florida 1 ;�� o, ,
Commission No. .ml \�SJ�\ (Seal)] {,.4' +� 4 Commission Nc'1�--\ \L9. \ (Seal) 4 ',••••:,.:0
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE . . .
RECEIVED _ _.
DATE
COMPLETED 1
Rev.8/2/17