HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /-�
Date: 218119 Permit Number: / ►/ ���
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COUNTY Y ::
l Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2200 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial _ Residential Yes
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PERMIT TYPE:Plumbing
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Address: 9821 Perfect Dr 182 -
Property Tax ID#: 3327-703-0134-000-9 Lot No_
• Site Plan Name: • Block No.
Project Name: Shower Valve/Pan Replacement
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Install 4'x 5'vinyl pan for shower -.-....
Install new Moen posi temp shower valve
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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:$ 885.00 Utilities: _Sewer Septic Building Height:
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Name Robert McKenna Namte:James Marsala
Address:9821 Perfect Dr 182 company:Peerless Plumbing&Drain Service
City: Port Saint LucieState: L Address: NW Enterprise Dr Unit 106
Zip Code: 34986 Fax: City: Port Saint Lucie State:FL
Phone No. Zip Code: 34986 Fax:
E-Mail: Phone No 772-223-1356
Fill in fee simple Title Holder on next page(if different E-MailjameS@peerlessplumbing.net
from the Owner listed above) State or County License CFC 1428692
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required,
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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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 the permit holder to build thesubject structure
which is in conflisu
ct with any applicable Home Owners Association rules,bylaws or anti 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 recording your Notice of Commencement. -
Signature of Owner/Lessee/Comet .ctor as Agent for Owner Signature of C actor/License Holder
STATE OF FLORIDA � , STATE OF FLORIDA ,
COUNTY OF �4-. r�� fly - COUNTY OF, ,S-k— L..c�C/ e
The forgoing instrum t was acknowledged before me The forgoing instrum t was acknowledged before me
this /( day of /�3,,1..,c7 ,20/Q by this //day of - ,-7 ,20 /?by
_ i
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification.' Personally Known OR Produced Identification A 22
Type of Identification Type of Identification
Produced (4 • • Produced ._ G —C Si . d j'0
,,--.111110111111r -
vijail 11,10
(•ignature of Notary Public-State of Florida) ,��ediI'Wiltle -
(Si-(5i- .ture of Notary Public-State of Florr �}�. G110,0% •
Commission No. • ( a(3Tj.:..\0 +commission No. - Gj` ed y
y $ , = E 4:My Comm.expires?' r.
July fS,P019 . • I Nc.FF899392 .
REVIEWS FRONT ZONING 9 Rf Eii.ANS VEGETATION SEA TairER .d Ai + :
COUNTER REVIEW�cS\ f FVIEW REVIEW w REVIE'G�!9 .�. �;�P,.'�+
DATE 1�i�� OF FV.As ,` CP/if,��.Oi FA \\` ''
RECEIVED lit,. OF
"
DATE
COMPLETED
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