HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: . I Permit•Number: O �
r t- RECEIVED
Building Permit Applicatil n
JAN, 2 3 2019
9 p ST. Lucie County, Permitting
Planning and Development
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL-34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT TYPE:PIUmbing
0P7St ,# }PFt(�1lMRtt "
Address: 304 Rio Mar Dr. Port St Lucie FL 34952
Property Tax I D#:3419-510-0062-000-3 Lot No.9
Site Plan Name: Block No. 11
Project Name:
DET!#!!ED C�ESCR10T
Replace 40 gals electric water heater in garage
77 777-771
cP]N$TRUctto�r r t c� n Trot
Additional work to be performed under this permit–check all that apply:
_Mechanical'- _Gas Tank Gas Piping . _Shutters _Windows/Doors
_Electric Plumbing `—Sprinklers _Generator _Roof Pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor'
Cost of Construction:$.1295.00 Utilities: _Sewer _Septic Building Height:
QrY ltlr_(��I.G�I:E 3,..;. C(31UTRACTQR` ti
Name Al VF L I*WC S LCL Name:Jay Palmer
Address:_ /J3 .f_tN J>ifN XCompany:Quality Drain Solutions
City: `r-f State:(C Address:PO Box 1466
Zip Code: 3 OPL Fax: City: Port Salerno State:FL
Phone No. 7 77 - 971- ///Z Zip Code: 34992 Fax:
E-Mail: Phone No772-220-7577
Fill in fee simple Title Holder on next`page(if different E-Mail qualitydrainsolution.s c@yahoo.com-
from the Owner listed above) State or County License CFC1427885
if value of construction is$2500 or more,a RECORDED Notice of Commencement Is r equired.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement Is required.
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 theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or anscove nants.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 permitapplications 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
commencen 'work or recording our.Notice of Commencement.
Signatur O er/L see/Cont actor as Agent for owner Signat yof ntra r/I_ic se'Holder
COUNTY OFSTATEOFFLORIDA , alM STATE OF COUNTY OF—
Th
The f r oing instru ent was acknowledge before me The fjLtinstrum nt was acknowledge fore me
thi day of 20 by this of 6 20 by
N e of qerson m king statement. ,Name of erson making statement.
Personally Known OR Produced Identification Personally Known IV OR Produced Identification
Type of Identificatiori Type of Identification
duProduced
; r &fAR PI
' ub
(Signature o � , pari$ Odisf)ate of Florida Signature of to 1' t fEbanial s)on�FF 191045
a * z
Commission#FF 191045 N" o�: My Comm.Expires Mar 31,2019 ,
Commission'N ` "mac mm.Exd6�Nlar 31,2019 Commission No. �`• °F�t�•`% Bondedthrc 331h)iona1NItaryAssn.
oF F�°`` BondedthroughNatlonal Not
Assn. -
41.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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