HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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COUNTY
F t. to t n Ate+
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 2045 Laurel Oak Ln
Property Tax ID ##:
Site Plan Name:
Project Name: _
4425-605-0045-000-1
Moreland Residence
Permit Number:.
Building Permit Application
Commercial Residential V
DETAILED DESCRIPTION OF WORK:
MEQ
Bathroom Remodel: New Shower Pan & Valve In Shower. Replacing Plumbing Fixtures.
CONSTRUCTION INFORMATION:
Lot No._
Block No.
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: $ 2,150.00 Utilities: _ Sewer T Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name John Moreland
Name: Jason Wintercom
Address: 2024 NW Laurel Oak Ln
Company:_ South Park Plumbing, Inc.
City: Palm City State:
Zip Code: 34990 Fax:
Phone No.
E -Mail:
Address: PO Box 768
City: Port Salerno State: FI
Zip Code: 34992 ,Fax: 772-287-2559
Phone No 772-287-2548
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail southparkpiumbing@live.com
State or County License CFC1426656
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 thepermit 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, l 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 COMMENCrEMENT.'
Si of Own / Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF St. Lucie
of Contractor/License Holder
STATE OF FLORIDA
CO U NTY O F St -Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 9 day of September 20Iq by this 9 day of September 20�a by
Name of person making statement,
Personally Known x OR Produced Identification
Type of Identification
Produced
Sign ur of Notary ul Florida
. .` ". Nota)y Public - State 01 flor
Commission No, *'= 1( o i
fission # GG 06222
My� � n, Expires Mar 18, 2
,'.,, No Bonded torough National Notary A
REVIEWS I FRONTZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification
F Nary Public t ."" * iidRJ1ary Public - State of Flt
" Eommissian # GG 0622'
. E
No. r or Oea4rn. Expires Mar 16,
11110
L, BoodeB through National Notary
SUPERVISOR I PLANS I VEGETATION SEATURTLE I MANGROVE
REVIEW REVIEW REVIEW I REVIEW REVIEW