HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
C.-
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 V
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential '\
PERMIT APPLICATION FOR: Plumbing
CATIOjA
Address: 10600 SOUTH OCEAN DRIVE, 5
Legal Description: OCEANA SOUTH CONDOMINIUM II UNITS AND UNDIV SHARE IN
COMMON ELEMENTS (OR 3528-1188)
Property Tax ID q: 4511-517-0005-000-3 Lot No.
Site Plan Name: Block No.
Project Name: WATER HEATER
Setbacks Front Back: Right Side: Left Side:
DETAILED DES
30-GALLON ELECTRIC WATER HEATER REPLACEMENT
ON' KI ON
Additional work to e er orme under this permit —checka appy:
HVAC El Gas Tank ❑Gas Piping Shutters ❑ Windows/Doors
11 Electric ✓❑_Plumbing Sprinklers 1:1Generator Roof Roof pitch
Total Sq. Ft of Construction: ScFt. of First Floor:
Cost of Construction: $ 1,939.00 Utilities: Sewer D Septic Building Height:
E -.NTRACTOR:
Name DEXTER STONE
Name: RICHARD BASSOFF
Address: 10600 S OCEAN DR 5
Company: ADMIRAL PLUMBING SERVICES
City: JENSEN BEACH State: FL
Address: 2895 JUPITER PARK DRIVE, 700
City: JUPITER State: FL
Zip Code: 34957 Fax:
Phone No. 508-451-2159
Zip Code: 33458 Fax:
E-Mail:
Phone No. 561-746-1180
Fill in fee simple Title Holder on next page ( if different
E-Mail: PERMITTING@THEADMIRALPLUMBER.COM
State or County License: CFC-1426115
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CQ LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY- Not Applicable
Name:_
Name:
Address:
Address:
_
City:_ State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address: 2895 JUPITER PARK DRIVE, 700
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 thepermitholder to build the subject structure
which is in conflict 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 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
comme cl ia work or recording vour Notice of Commencement. _ I,-1
Rev. 8/2/17
Signatj6reof Owner/ Les e/ nt ctor as Agent for Owner
Si a a re of Contractor/Li nse H er
STATE OF FLORIDA'
STATE OF FLORIDA
COUNTY OF PALM BEACH
COUNTY OF PAur BEAcH
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 18 day Of JANUARY 20_ by
this 16 day of JANUARY 20_ by
RICHARD BASSOFF
RICHARD BASSOFF
Name of person making statement
Name of person making statement
Personally Known x OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced�%
Produced
/
(Signature of(Signature
.: NICOLE M SUL IVAN
of N
•„�,• - Rjj' LLI AN
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Commission 6.1:
,' MY COMMISSION*91)043125
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Commission No
,
:� MY COMMISSIO C p043125
EXPIRES Octo er ��3jj)�'. 2020
EXPIRES October 30.2020:3•gh,,.'
1
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17