HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11-29-2018 Permit Number:
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: To Select from dropbox, click arrow at the end of line III
PROPOSED IMPROVEMENT LOCATION: �II
Address: 8916 Champions Way
Legal Description: Lakes at PGA Village PB43-32 BLK A LOT 52 or 2869-1218
Property Tax ID #: 3334-501-0066-000-3
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side:
DETAILED DESCRIPTION OF WORK:
Replace water heater, ELECTRIC 40 Gal
Left Side:
Lot No.
Block No.
CONSTRUCTION INFORMATION:
A4
work toe e orme under t—checkispermit a appy:
❑HVAC 11GasTank E]GasPiping _Shutters Windows/Doors
11 Electric ❑✓_ Plumbing FISprinkiers 11 Generator L]Roof = Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1000.00
SFt. of First Floor:
Utilities:]Sewer OSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Stanley and Darlene Pry
Name: Jason Parish
Address: 8916 Champions Way
Company: All City Plumbing Two Inc
City: Port St Lucie State: FL
Zip Code: 34986 Fax:
Phone No.
Address: ?O &N 95)0(aL4
City: Port St Lucie State: FL
Zip Code: 34988 Fax:
Phone No. 772-828-1331
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: holly@allcityplumbingtwopsl.com
State or County License: CFC1427492JK
IT value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
---•--�r��omccn: = Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not
Name: Applicable
Address:
City:
Zip: Phone:
OWNER
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip Phone:
BONDING COMPANY: _Not Applicable
Address:
City:
Zip: Phone:
/ 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,
un
no
which ism onflictawith any representation
Home at is Owners Asssociati ndrules,by bylaws or anscovenants that build
ct of 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 pilyin` twke 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 recordins your Notice of Com,n pnr.r .-,
Sign +r o Owner/ Less ntractor a$ Agent far Owner
STATE OF FLORI
COUNTY OF
Thef g Ing instrument s acknowledge efore me
this ay of
20by
Name of perso making statement
Personally Known V OR Produced identification
Type of Identification
ibignature of No ary pjltblij Site of Fl6ry— ) 'mob
Commission No.L1 .)?I� *GG+stn
ITF
REVIEWS FRONT I•rrrnm
ZONING SUPERVISOR
.r. COUNTER REVIEW REVIEW
Rev.
STATE OF FLORIDA
COUNTY OF_
The foSgging instru acknowledgegbefore me
this ay of 2p + Y by
Name of person aking statement
Personally Known �OR Produced Identification
Type of Identification
Commission No.
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PLANS VEGETATION
REVIEW REVIEW
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REVIEW REVIEW