HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/03/2018 Permit Number:
Building Permit Application S�gNN��
Planning and Development Services ' I, r
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential J
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:'.
Address: 253 NE Prima Vista Blvd - Port St. Lucie, FL 34983
Legal Description: RIVER PARK -UNIT 5 BLK 43 LOT 3 (MAP 34/28N) (OR 3571-728).
Property Tax ID /f: 3419-540-0003-000-5
Site Plan Name:
Project Name: Water Heater Tank -FLB
Setbacks Front Back:
Code Standards.
—Right Side: Left Side:
Lot No. 3
Block No. 43
DETAILED DESCRIPTION OF WORK: Ill
Reconcile existing electric
standards.
tank installed by others in garage to FL building code
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name TIF -FK -B LLC ek, 5- Florida Field Services
-
Itmna wor iocrfirtormed under
❑HVAC Gas Tank
tIs permit—c heck a
Gas Piping
appy:
_ Shutters
Windows/Doors
11 Electric ❑✓_Plumbing
Sprinklers
11GeneratorRoof
Roof pitch
Total Sq. Ft of Construction:
SrLFt.,
of First Floor:
Cost of Construction: $ 200.00
Utilities
nSewer D Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name TIF -FK -B LLC ek, 5- Florida Field Services
Name: Robert W. Ludlum
Address: 253 NE Prima Vista Blvd
Company: Benjamin Franklin Plumbing
City: Port St. Lucie State: _
Zip Code: 34983 Fax: his
Phone No. 772-871-9494
Address: 1631 SW South Macedo Blvd
qty: Port St. Lucie State: FL
Zip Code: 34984 Fax: 772-871-9069
Phone No. 772-871-9494
E -Mail: Na
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: permits@benfranklinplumber.com
State or County License: CFC1426801
It value or canna ucrion rs $Zsuu or more, a aewnutu Nonce oT Lommencemem: Is reaulrea.
i1w.
appce2 n-13115
9A
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Sign of CorTractor/Licelfse Holder
Address:
OF FLOR% per•:•.
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_Not Applicable
BONDING COMPANY:
Name:
Not Applicable
Address:
Personally Known OR Produced Identificati
Address:
Type of Identification :.',:^-„ RHONDA LAFFER
City:
Produced ;J•=-
= V COMMISSION p GGOS
City:
EXPIRES January 08, 2(
Zip: Phone:
20
Zip: Phone:
(Signature of No Publi ` Fl.rWIRES January 08.202
OWNER/ CONTRACTOR AFFIDVIT: Aoolication is herebv made to obtain a Dermit 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 Count makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in confylict with any applicable Home Owners Association rules, bylaws or an 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 roams 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
commencine w24 or recordinlc vour Notice of Commencement. /)
Rev. 8/2/17
Si a reo'Ovot r/ essee/Contractor as Agent for Owner
Sign of CorTractor/Licelfse Holder
STATE OF FLORIDASTATE
S La
OF FLOR% per•:•.
COUNTY OF 1n
COUNTY OF OO�A
The for oing instrument was acknowledged before me
this dayof ilDtw.,..lio+ .201�by
The f__orggpping ins rument was acknowledged before me
this "day of i 20 by
Pahp �l�dluw�
O -L A LkakUVk
Name of person making statement
Name of person making statement
Personally Known � OR Produced Identification
Personally Known OR Produced Identificati
Type of Identification
Type of Identification :.',:^-„ RHONDA LAFFER
Produced
Produced ;J•=-
= V COMMISSION p GGOS
RHONDA LAFFERT
EXPIRES January 08, 2(
&WL My OMMISSION p GG058
20
( ignature of Notary Public -State of Florida)
(Signature of No Publi ` Fl.rWIRES January 08.202
Commission No. o ea
Commission No. GG 051rja6 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17