HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I ` I Permit Number: ✓
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Planning and Development Services permitting Department
Building and Code Regulation Division St, Lucie county
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:Plumbing
:P'ROPOSED tIVIPRQUEMENT LOCATION_
Address: 4203 Redwood DrFort Pierce, FL 34951
Property Tax ID#: 1313-502-0109-000-9 Lot No.532
Site Plan Name: Block No.
Project Name:
QETAILED
DESCRIPTION OF•WORK
Whole house re-pipe, plumb in uponor pex pipe
,CONSTRUCTION INFORMATION: T
a ..t
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric ,L( Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 9500.00 Utilities: _Sewer —Septic Building Height:
OWNER/LESS.EE y CONTRACTOR3.1
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Name Beryle&Arlene Newson Name:Anthony Fioretto
Address:4203 Redwood Dr Company:Quality Plumbing &Drains
City: Fort Pierce State:_ Address:PO Box 1466
Zip Code: 34951 Fax: City: Port Salerno State:FL
Phone No.772-466-3132; Zip Code: 34990 Fax:
E-Mail:berylen@comcas#.net Phone No772-220-7577
Fill in fee simple Title Holder on next page(if different E-Mail info@qpd.plumbing
from the Owner listed above) State or County License 3�l7?-
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.
S'UPPLEMENTAL CONSTRUCTIONUEN LAW-INFORMATION:
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."
Signature of Owner Lessee/Contractor as Agent for Owner Signature of Contractor/Lic nse Frolder
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STATE OF FLORIDA]
�l�( n , STATE OF FLORIDA j v
COUNTY OF l_. - COUNTY OF
The fo oing instru en was acknowledge4,before me The for of g instru was acknowledged before me
this day of 20 L"/by this ay of 20 by
OAW-)15y-�k F! 6P4 tiL n 60-41 h in,c6t5
Name of person making statement. Name of person making stateme .
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification / Type of Identification(
Produced '- li_ D Produced
(Signature of Notary Public-S t1,o ! �Jgri a ELLEN VAUGH ture of Notary Public-State of Florida)
?a° ;State of Florida-Notary ublic
mission #GG 27 "wYp`'' ELLE(f9ea
Commission No. _' o��S�&Ir 0¢® fission No. .P °e% UGHN�
olF;o�,` My Commission Expires :* �__ ate of Florida-
October 22 2022 3 oma Commission #Notary Public
OF,FU5` omm ss on Expires
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COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
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