HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
COU TY
F L O R I F7 A
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34952
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 1861 WALDEN POND DRIVE
Property Tax ID #: 2303-211-0025-000/5
Site Pian Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Permit Number:
Building Permit Application
Commercial Residential xxx
LIKE FOR LIKE, REMOVE AND INSTALL NEW 30 GALLON ELECTRIC WATER HEATER
CONSTRUCTION INFORMATION:
Lot No.
Block No.
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: $ 800
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name JOHN RICHARD
Name: JOSEPH DURAN
Address: 1861 WALDEN POND DRIVE
Company: First Choice Plumbing Solutions
City: FORT PIERCE State: _
Zip Code: 34945 Fax:
Phone No.
Address: 1687 SW MACEDO BLVD
City: PORT SAINT LUCIE State: FL
Zip Code: 34984 Fax:
Phone No 772-879-1414
E -Mail:
Fill in fee simple Title Halder on next page ( if different
from the Owner listed above)
E -Mail firstchoiceplumbingsolutions@gmaii.com
State or County License CFC1427369
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: —Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, i do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency ree : room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses t another non-resi ential use
r�
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESGLT IN YOUR PAYING
TWICE FOR IMPROVE NTS TO YOUR I RWPERTY. A NOTICE OF COMMENCEMEN, UST BE RECORDED AND
POSTED ON THE JOB Sft BEFORE THE FIRST INSPECTION. IF YOU INTEND T"BAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN*TTORNEY BEFORE RECORDING YOUR NOVICE OF/COMMENCEMENT."
ev. 1
Signature of O er/ L$�see/Contractor as Ag nt for Owner
Signature of Contra License Holder'
STATE OFFLORIDA�� Y
STATE OF FLORIDA
COUNTY F : l� ��� < -_
COUNTY OF
The fosing instrument was acknowledged before me
T
this ? day of 1 t� r > > 20 S by
t acknowledged efore me
The forgoing instrum nwas
this day of t 20 by
,
Name of person making statement.
Name of person making statement..
Personally Known OR Produced Identification
Personally Known �r OR Produced Identification
Type of Identification
Type of Identification
Prod ,ed.
Prod d
i
r
C41A
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Al
(Signature of Nota Public- Stat of Florida j
(Signature of Notary Public- State of FJo id�
Spj,y Ariana Veneziano
Oily Arrana neziancr
Commission No. NOTJ§yd� JBLIC
STAT OF FLORIDA
Commission No. NOTA P LSC
_STATE ORIDA
= Comm# GG185914
= Comm* GG185914
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REVIEWS
FRONT ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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