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DEC/13/7018/7HU 11 :35 Am FAX N0, 561-744-7101 P. 002
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ALL AOLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0 ,...‘
COUNTY '.
RECEival
Building Permit Application On 1 3 2018
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Planning and Development ServicesBuilding and Code Regulation Division I 9 DePartment
St Lucie CoUnty
2300 Virginia Avenue,Fort Pierce FL 34982 i
Phone! (772)462-1553 Fax: (772)462-1578 Commercial I Residential x
PERMIT APPLICATION FOR: Plumbing ,
1 LAKE VISTA TRL 205
VISTA ST LUCIE BLDG 1 UNIT 205(OR 4003-2721)
Legal Description:
Property Tax ID#: 3422-500-0012-000-7 Lot No_
| Site Plan Name: _ Block No.
WATER HEATER .Project Name: ,
Setbacks Front Back: Right Side: Left 5icie:30- GALLON ELECTRIC WATER HEATER REPLACEMENT ,
0 HVAC Lj das Tank , Das Piping Shutters Ei Windows/Doors
.„,,_Electric Ft:1 Plumbing Li Sprinklers ...1 Generator ED RoQf Ropf pitch
Total Sq. Ft of Construction: Sillti of First Floori
1,314.00
Cost of Construction:$ Utilities:I 'Sewer[256tic Building Height: I
2301 NE SAVANNAH RD UNIT 1634 ..ADMIRAL PLUMBING SERVICES
City: JENSEN BEACH State:FL Address: *2895 JUFIITER PARK OR,700
Zip Code: 34958 Fax: City: JUPITER I State:FL
Phone No. 561-762-1137 , Zip Code: 33458 Fax:
E-Mail: 1 Phone No, 561-746-0180
Fill in fee simple Title HOIldgr on next page(if different Email: PERMITTINOQTHEADMIRALPLUMBER.COM
from the Owner listed
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if value of constructiOn is$2500 a
ECORDED Notice of Commencement Is regluired.
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DEC/13/2018/THU 11 :36 AM FAX No, 561-744-7101 P. 003
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DESIGNER ENGINEER: Not Applicable MORTGAGE COII/IPANY: 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:2885 JUPITER PARK DR,700 Address:
City: city:
Zip: Phone: Zip: 'Phone:
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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. I
5t_Lucie County makes no representation that is granting a permit will authorize the pe mit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and c venants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed fo any restrictions which may apply_
in consideration of the granting of this requested permit, I do hereby agree that I will,i all respects, perform the work
in accordance with the approved plans,the Florida Building Codes and St_Lucie County mendments.
The following building permit applications are exempt from undergoing a full concurre cy 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 recording your Notice of Commencement.
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Si.t azure of Owner/Lesser Co .! act,_as Agent for Owner Signatur of ntraator/License 6.Ide
STATE OF FLO 7 a • . STATE OF FLORIDA. n
COUNTY OF ' . 1.Y- 1 • Cr) • COUNTY OF , 110.c�t ()
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The for oing instrj.{ ent was•acknowledged efore me The fa oing Inst ent was acknowledg d,before me
this, day of US,C 0 4('1. {,20 1 0 by this day of � CaQ�20� by
0/1/C4 r-Cil 606 s•o 'f'.-
R ima 0 t'o C3 t IT
Name of perso�yi'h, son aking statement Name of p raking statement
Personally Known 1h`�� OR Produced Identification Personally Known _OR Produced Identification
Type of identification Type of Identification m •
Produced Produced
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1 1) ( L W.),1,0,(q3 fl1UJtLLLDOfl___
(Signature of Notary ;43idnNICOLE�) SULLIVAN (Signature of Notary ubiic-State of iorida)
Commission No. ' = MI A MY OOMN#GG043125 Commission No.
NICOLE SiN LIVAN
,, ,, 5XPIRE8 October 30,2020sr Mr COMMIS ON#GG043125
ff.,-414• EXPIRES October 30,2020
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGET4TION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE 1
RECEIVED .
DATE
COMPLETED i �
Rev_8/2/17