HomeMy WebLinkAboutBuiding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Data: 4/12/19 Permit Number:
COUNTY
F L O R t D A
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Commercial Residential X
PERMITTYPE:PLUMBING WATER LINE REPAIR
IMPROVEMENT LOCATION:
Address: 105 S NARANJA AVE PORT ST LUCIE FL 34983
Property Tax ID If: 3419-540-0157-000-9 Lot No.20
Site Plan Name: RIVER PARK -UNIT 5 BILK 47 LOT 20 (MAP 34/28N) (OR 3276459) Block No. 47
Project Name: WATER LINE REPAIR FROM METER TO HOUSE
DETAILED DESCRIPTION OF WORK:
35 FT OF 3/4" PVC WATER LINE REPAIR FROM METER TO HOUSE IN FRONT YARD
CONSTRUCTION INFORMATION:
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:,
Cost of Construction: $ 2000
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameTIMOTHY J HORTON
Name:ROBERT LUDLUM
Address: 105 S NARANJA AVE
Company: BENJAMIN FRANKLIN PLUMBING
City: PORT ST LUCIE State: _
Zip Code: 34983 Fax:
Phone No.
Address: 1631 SW SOUTH MACEDO BLVD
City: PORT ST LUCIE State:FL
Zip Code: 34984 Fax: 772 -871 -9069—
Phone N0772-871-9494
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail PERMITS@BENFRANKLINPLUMBER.COM
State or County License CFC1426801
o.BrucDen D>cow or more, a newnucu notice or commencement Is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
x Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
COUNTY OF s. waE
Address:
The forgoing instrument was acknowledged before me
City:
Zip: Phone
State:_
City:
Zip: Phone:
State: _
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Personally Known �-V OR Produced Identification_
Address:
Type of Identification
City:
Produced
City:
No1e,Y
C mission No. ipgli Graham aFy
GG20oa0Z m fission No.
Zip: Phone:
9 pFF dplrp01OR2022
Zip: Phone:
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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.
Inconsideration 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 THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOIWZENDER OR RNEY BEFORE RFCOMMC YOUR NOTI[F OF fOMNFNffNFNT
nature o ner/ less re/Contractor as Agent for Owner
gk66ffire of ContractoFAIiciFinse Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF sr waE
COUNTY OF s. waE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this/.?-dayof 20-ff by
this/. day of y ri% 201? by
�.ras
�.x i,.rrw
c�[s/fires
.C�fG'
Name of person making statement,
Name of person making statement.
Personally Known _,36 OR Produced identification_
Personally Known �-V OR Produced Identification_
Type of Identification
Type of Identification
Produced
Produced
(Signal of Notary P ' - ignature otary Pu
Publb Sba d FMtla
No1e,Y
C mission No. ipgli Graham aFy
GG20oa0Z m fission No.
IM minion LMp
VExPiN8011=029 y x w ON11Illft 002 MM2
9 pFF dplrp01OR2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
laS S. AVe
l7oc} 5f G -6e- ,Fl-. 34483
18
em
P4W1
Gof6Lly,
aas
19 (977)
ron
APSA
(150)
35-O&P
Ski" PUC
W4eHine
PL