HomeMy WebLinkAboutBuilding Permit Application i
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. �`a a`1� Permit Number: v3'
a= En
IVED
" ® 2019
Building Permit ApplicatiPlanning and Development Services ntYt Pcfrfllttifl9__
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT TYPE:Swimming Pool Heater
M00
Address: 65 Aqua Ra,Dr Jensen Beach, FL
PropertyTaxlD#: `y1 ��� �$�S"' dd�1 '�a�`� Lot No.
Site Plan Name: Block No.
Project Name: Eberle
Install new electric pool heater
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Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
X Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 2499 Utilities: _Sewer _Septic Building Height:
—."" '_'-'
U1f„t�IER�E�SSE� �-�_
Name Mary Ann Eberle Name:Richard Maaoli
Address:65 Aqua Ra Dr Company:Causeway Pool and Patio
City: Jensen Beach State: 1:L Address:1114 NE Jensen Beach Blvd
Zip Code: 34957 Fax: City: Jensen Beach State:FL
Phone No.561-248-1637 Zip Code: 34957 Fax:
E-Mail: Phone No 772-4443213
Fill in fee simple Title Holder on next page(if different E-Mail maaolimark@gmail.com
from the Owner listed above) State or County License CPC1459.36
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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PPCEFiVIEtA�CQISTRECTQV .tN LA�I�fi1ORl�/fATtQ�t
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Add ress: Add ress:
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 the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and 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 JOB SITE BEFORE THE FIRST INSPECTION. IF- U qQTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORD OF COMM€NCEM€ ."
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Signature of Oer/ essee/Contractor as Agent for Owner Sig ature f ontractor/License d
STATE OF Ft(ORIDA STATE OF FLORIDA ll -
COUNTY OF ST AAe-i 6 COUNTY OF e
The forgoing instrument was acknowledged before me The for strument was acknowledge cj before me
this /-4—,T dayof 20� by / thi o da f 20 `�� by
/ —
Name of person making stateinent. Na a of person making sta ent.
Personally Known ✓/OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Prod ce Produced--—,
(Signature of Ndfary Public-State of FI i ) (Signature of Notary Publi -State of Florida)
Commission No. ° YPue�'� �COMMISSI OO�Z006 Commissiq RIWARD M.MAllOLI (Seal)
:° * MY COMMISSION*GG 002006
g, o� EXPIRES:August 25,2020 * ust25.2020
'110Fl% °ea amcled71w BU i9stNOtafYServos
REVIEWS FRONT ZONING SUPERVISOR PLANS 16033ETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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