HomeMy WebLinkAboutBuidling Permit FALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED C� \`
Date: Permit Number: 1 ')1
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 Ves
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 2210 bell avenue fort Dierce fl 34982
Legal Description: 28 35 40 from sw cor of sec run my 40 ft alq sec Li th elv 642.45 ft for pob,th cant
elv 152 ft.th my 302.58 ft th wly 152 ft. th sly 302.58 ft.to Dob (1.06 ac) (or 4083-2094)
Property Tax ID#: 2428-331-0001-210-9 Lot No.
Site Pian Name: Block No._
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
replace existing water heater with new. 50 GALLON ELECTRIC
CONSTRUCTION INFORMATION:
Additional work toe e rme under this permit—check a app y:
HVAC 11 Gas Tank Gas Piping F]Shutters Windows/Doors
Electric Q Plumbing FSprinklers 11 Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 985.00 Utilities:0Sewer®Septic Building Height:_
OWNER/LESSEE: CONTRACTOR:
Name,IFNNIFFR KFMPFR Name: Ai FXANnFR RFRF7
Address:2210 BELL AVE Company: DOM BELLA PLUMBING LLC
City: FORT PIERCE State:FL Address: 6104 NW BUTTERFLY ORCHID PLACE
Zip Code: 34982 Fax: N/A City: PORT ST LUCIE State:FL
Phone No.405-812-8324 Zip Code: 34986 Fax: N/A
E-Mail:JERADKEMPER @SBCGLOBAL.NET Phone No. 772-222-5570
Fill in fee simple Title Holder on next page( if different i E-Mail: DOMBELLAPL@GMAIL.COM
from the Owner listed above) State or County License: CFC*1429752
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAWINFORMATION:
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: 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 thepermit 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 recordipffVour Notice of Commencement.
Pignature 'f O n Lessee/Contractor as Agent for Owner re of ntrac (License Holder
STATE OF FLWRASTATE OF FLORIDA
COUNTY OF �i N- tife COUNTY
The oing instru en a ack wled before me The forgoing instru int\ a ckn wrledg before me
thiscday of 2Q by thin day of c_ 2Q by
Name of person making statement Name of person making statement
Personally Known OR Produced Identification ✓ Personally Known OR Produced Identifica`ion
Type of Id if Con. Type of Id if' o f
oduced <t oduced L
nature of Notary g of Florid
IA BREW ignature of Notary Public` t o S!� rida) MARIA BREWER
Y Notary Pu lic-State of Acrida �` :�*��"tr° Notary Public-State of Hui a .
Co r. # GG 059091 =' ° i;sio! ff GG 059 9 't
Commission N '. �19 Commission Nd.7� �. (S@rn'
oFn���.�� My Comm.Expires Jan 17,2021;' ! I%",;��F�d;' My Comm.Expires Jan 17 2:21
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17