HomeMy WebLinkAboutBuilding Permit Applicaiton ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: L}—5...0)-0 Permit Number: 19, Oar- Or?an
COLI N TY
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Building Permit Application ,qPM �Fc'0/,
Planning and Development Services �'
Building and Code Regulation Division 5''�lr%9 ®�(0
2300 Virginia Avenue,Fort Pierce FL 34982 �4c.• O04
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resicferla , X •
PERMIT APPLICATION FOR: Pl/u►mjbing
Rd*dSED jPROVEMEN LOT1CN
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Address: 4:57 7 Ai 60 $4'tt1dieAS5 C44-y /Ac-n etill $�/ 9®
Legal Description: HARBOR RIDGE-PLAT 13-BUTTONBUSH VILLAGE UNIT 53(OR 687-618)
Property Tax ID#: 4426-815-0060-000-0 Lot No.
Site Plan Name: - Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
rD A LEiI�5ESCRIPT1ON�{ F'WORK ���s �•- N r
REMOVE EXISTING 250K LP HEATER & REPLACE WITH NEW GAS HEATER
PENTAIR P/N 460733 250K LP GAS HEATER
MORNINGSIDE POOLS LP GAS LICENSE SPECIALTY INSTALLER C CERT#29627 LIC # 32783
C N T6o4tINeORme4 ;j4 � w —.. . k ao t " ; i
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citional wrktobe�rforcunder this permitcheckll - apply: J. f ,. r . �. , r . .
❑HVAC _Gas Tank nGas Piping Shutters LI Windows/Doors
❑Electric ❑PlumbingSprinklers ❑Generator Roof
Elp ❑ Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 2200 • Utilities: _Sewer 0 Septic Building Height:
iWN Rttit Shill,> -43 t E dNTRACTOR , 'x k f
Name Barbara Stone - Name: Frank A DeTura
Address:1507 NW Sawgrass Way Company: Morningside Pools
City: Palm City State:FL Address: 1768 SE Port St Lucie Blvd
Zip Code: 34957 Fax: City: Port St Lucie State:FL
Phone No.772-285-3399 Zip Code: 34952 Fax: 772-337-2737
E-Mail:stonebarbj@hotmail.com Phone No. 772-337-7151
Fill in fee simple Title Holder on next page(if different E-Mail: morningsidepools@bellsouth.net
from the Owner listed above) State or County License: CPC-1456784
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER. Not Applicable MORTGAGE COMPANY: d Not Applicable
Name: Name:
Address: Address:
City: ! State: City: State:
Zip: Phone Zip: Phone: /Not SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: t,/ 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 represu
sentation that is granting a permit will authorize the permit holder to build thesubject 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencin: work •._.ecordin• our Notice of Commencement.
41 4, 7
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Signature of Owner/Lessee/C•ntractor as Agent for Owner Signature of Contracts/Lice se Holder
STATE OF FLO A STATE OF FLORIDA
COUNTY OF Ct e COUNTY OF �S.t L-
The forgoing instrment wa acknowledged before me The forgoing instru ent was acknowledged before me
this Oday of (' r ,20't 9 by this3O day of npc . 1 ,20(,ci by
Name of person making statement Name of person making statement
Personally Known V— OR Produced Identification Personally Known 1/ OR Produced Identification
Type of Identification , Type of Identification
Produced Produced v
• a j--t-Akt--s- q)k_12_,Jc, o14 .
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
!!'� Log Fl BRENDA A.USTER :Peet, BRENDA A.LUSTER
Commission Nom& I (o- l0 %*ea�tGG167Commission Nord 7(ig ' mon# ,3(3167484
741 Expires January
Expkes January 25,2022
'40,0-- BaieedthuBS,
uixOlorys s +Ire„0.0!a� Banded Mil Mad Norrysweet
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17