HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/2/19
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
PERMIT TYPE: Plumbing Permit
Address: 4700 Eagle Drive Fort Pierce FI. 34951
Property TaxID #: 1312-801-0036-000-1
Site Plan Name:
Project Name: J Matz
Residential X
Lot No.
Block No.
Supply and install pex "a" pipe throughout home from main to each fixture due to failing copper tubing under slab
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: $ C-'X`SZ' C%
City:
Zip Code:
Phone No
E-Mail:
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
State:.
Fill in
fee
simple
Title Holder on next page (if different
from
the
Owner
listed above)
Name: Robert C Perry
Building Height:
Company:CDA Solutions dba ServiceMax Plumbing
Address:7622 Emerald Drive Suite 5
City: West Melbourne State: FI
Zip Code: 32904 Fax: (321) 674-9143
Phone No (321) 574-8990/ (772) 473-4401
E-Mail Brittney.servicemax@gmail.com
State or County License CFC057059
value
of construction is
$2500 or
more, a RECORDED Notice of
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
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."
Signature of Owner/ Lessee/Con ractor as Agent for Owner
Signature of Contractor/License Molder
STATE OF FLORIDA
COUNTY OF % A � �'
STATE OF FLORIDA
COUNTY OF? i! x V` C�
The forgoing instrument was acknowledged efore me
this day of i t 26Z by
The forgoing instrument was acknowledged before me
this day of `, U 20 by
Name of person making statem nt.
Name of person makin statement.
Personally Known OR Produced Identificatio
Personally Known OR Producedldent
Type of Identification
Produced .•^"d•P• CHELSE ACONKLIN
/� 1 Notary u State of Florida
f$��'� y^p�� Cammfsslon A OG 2201322022
'ub+.%�) M Comm. Exp Ives dun i,
•.'' F h.•�' y
" d through National Notary Assn.
Type of Identificati 01.1 11 CHELSEACONKLIN
Produced ~s��°4`•: State of Florida
otary-Rubl!o-'
Q Cammisson N GO 220732
,.,?'or rv`r" My Comm. Expires Jun 1, 2022
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°"" Bonded through National Notary Assn.
OWN
(Signature of Notar on a) -
(,q s
Commission No. t !L)' \f �R
(Signature of Nota t{b ic- State of Florida ) .
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ommission No. `� �%17 E•'`� al)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2 7 19