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 X
PERMITTYPE:Plumbing
PROP,OSEp ]i�IPftQ�/�MENT �OCAT10(��, ,sx_ � N _; }
Address: 4160 N HIGHWAY Al 302 A
Property Tax ID #: 1423-506-0009-000-8
Site Plan Name:
Project Name:
IncTall Tanklacc N/aior Hoator
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 3175,00 Utilities: —Sewer _ Septic Building Height:
Lot No.
Block No,
Windows/Doors
_ Roof Pitch
OWNER;%LESSEE
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_ r
Name Donald Janereth
N�..
me: Donald Rice
Address:4160 N HIGHWAY Al
302 A
Company: Cookes Plumbing and Septic
City: Ft. Pierce
State:
Address: 3100 SE Waaler St
City: Stuart State: FL
Zip Code: 34949 Fax:
Phone No. 772-465-2820
Zip Code: 34997 Fax: 772-287-1570
E-Mail:
Phone No772-287-0651
Fill in fee simple Title Holder on
next page
( if different
E-Mail cduque@cookesplumbing.com
from the Owner listed above)
State or County License CFC056684
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.
_ Not Applica
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _Not Applicable
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Phone:
BONDING COMPANY: _Not Applicable
Name:_
Address:
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.
Inconsideration 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."
Lessee/Contractor a(f Agenjf6r Owner
STATE OF FLORI /
COUNTY OF Lt)1'I/
The forgoing instrument was acknowledged before me
this�dayof �tfxrlS-�' ,20�by
Name of person making statement.
Personally Known �// OR Produced Identification
Type of Identification
GONNA M. ZIBRIN
MYCOMMISSION # GG 323452
EXPIRES: July 91 2023
Signature or contractor license n r
6 r
COUNTY OF /^
STATE OF FLORIDA
The fo going instru ent was acknowledge efore me
this day of (l `L 20 by
plo�o 46
making statement.
Name of person
Personally Known OR Produced Identification
Type of Identification
�ONNq M.21 H
of No1/ar� Public
Commission No.
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