HomeMy WebLinkAboutBuilding Permit Application i
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:� ~ 2� Permit Number: � U '
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Building Permit Applicatj,p�,rr9.e you
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Planning and Development Services WO
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMITTYPE:PIUCT bang
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Address: 3807 S Avenue S Ft. Pierce, FL 34947
Property Tax ID#: 2405-601-0124-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Andrews
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Install New Walk in Tub in existing Shower pocket area, No Tile or Dry Wall work being done
it
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:$ 1700.00 Utilities: —Sewer —Septic Building Height:
Name James Andrews Name:Michael Coleman
Address:3807 S Avenue S Company:Prefab Plumbing Inc
City: Ft. Pierce State:_ Address:1100 Carr St
Zip Code: 34947 Fax: City: Palakta State:FL
Phone No.772-465-1574 Zip Code: 32177 Fax:
E-Mail: Phone N0386-546-7643
Fill in fee simple Title Holder on next page(if different E-Mail mgc1980@gmail.com
from the Owner listed above) State or County LicenseCFC043003
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 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 YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Si ature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OFF D STATE OF FLORIDA ^
COUNTY 0 ��-LICOUNTY OF ��)(��G�-�'
The fo oing instrugat was acknowledg cj,�efore me The for oing instrument was acknowledged efore me
thi day of (� 20 by thisday of 201V by
� Amlpze-W3 �� ��
Name of person makilng statement. Name of person making statement.
Personally Known OR Produced Identification ersonally Known � OR Produced Identification
Type of Ide ' ' at'on Type of Identif'
Produce Produced
(Signature tar P tats gf ori a (Signature ---------------
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KATHRY Public State of Florida v P Notary Public State of Florida
ER Commission No. '�-' lV1y Comms G 049.422 Commission No. . KATHRYN R
ornr xpires 11/21/2020 Commissi r GG 049422
Diad Expires 11/21/2)20
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REVIEWS FRONT ZONING SUPERVISOR PLANS .VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.21,1,19