HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential xxx
PERMIT TYPE: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 775 SE AIROSO BLVD
Property Tax 1D #: 3419-545-0046-000-3
Site Plan Name:
Project Name:
Lot No._
Block No.
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE, REMOVE AND INSTALL NEW 50 GALLON L CAS WATER HEATER FROM C�q�AC�E
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping
Electric umbing
Total Sq. Ft of Construction:
Cost of Construction: $ 800
Sprinklers
Shutter`
Generator
Sq. Ft. of First Floor: _
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name SANDRA MACDONALD
Namg: JOSEPH DURAN
Address: 775 SE AIROSO BLVD
City. PSL State: _
Zip Code: 34983 Fax:
Phone No.
Company: First Choice Plumbing Solutions
Address: 1637 SW MACEDO BLVD
City: PORT SAINT LUCIE State: FL
Zip Code: 34984 Fax:
Phone N o 772-879-1414
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail firstchoiceplumbingsolutions@gmail_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 dome 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 FAILURE TO RECORD A NOTICE OF COMMEN T MAY RESULT IN YOUR PAYING
TWICE FOR IMPR TE NTS TO YOUR PROPERTY. A NOTICE OF COMM NC ENT MUST BE RECORDED AND
POSTED O THE J08 S RE THE FIRST INSPECTION. IF YOU INTEiD T OBTAWL.EENANCING, CONSULT
WITH YOUREN AN ATTORNEY BEFORE RECORDING YOUR NOTICE O IENCEMENT.
Signature of wne LesiContraktior as Agent for Owner
Signature of C ntr r/License I older
STATE OF F ORI A
STATE OF FL RI A
COUNTYOF` 3 L=�_\ �__''
COUNTYOF
The forgoing instrument was acknowledged before me
The f� rg�oing instrument was acknowledged before me
this 4& day of S` t_ � .�. 20 \�' by
this �. O,, day of � " � --tip - . 20 0k by
Name of person making statement.
Name of person making statement.
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Personally Known 3� _ OR Produced Identification
Personally Known OR Produced Identification
Type f Identification
Type of Identification
Prod ed
Produced
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(Signature of Notarypublic- State I Florida)
(Signature of Notary Publi - State of Florida
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Commission No. NOTARY Pt�SUO)
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DATE
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