HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09/26/2019 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 V
PERMIT TYPE: Single Water Supply Line Re -Route
Address: 8604 Paso Robles Blvd - Fort Pierce, FL 34951
Property Tax ID #: 1301-611-0299-000-5
Site Plan Name:
Project Name: Single Water Supply Line Re -Route
Lot No. 2
Block No. 115
Re-route three quarter inch single [cold] water supply line overhead from garage wall interior to manifold at kitchen wall interior.
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
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2000.00 Utilities: _ Sewer _ Septic Building Height:
Name Bertha M. Flinn
Address: 9804 Paso Robles Blvd
City: Fort Pierce State:
Zip Code: 34951 Fax: n/a
Phone No. 772-871-9494
E-Mail: permits@benfranklinplumber.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Pitch
Name: Robert W. Ludlum
Company: Benjamin Franklin Plumbing
Address: 1631 SW South Macedo Blvd
City: Port St. Lucie State: FL
Zip Code: 34984 Fax: 772-871-9069
Phone No 772-871-9494
E-Mail permits@benfranklinplumber.com
State or County License CFC1426801
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.
DESIGNER/ENGINEER: _ Not Applicable
Name:_
Address:
City:
Zip:
Phone
State
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
tate:
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 � F��I"�-ING, CONSULT
i WITH YOUR ENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCED4 T?'
Signature of Owne or as Ben "for Owner
Signature of Connr ctor iicense Holder
STATE OF FLORIDA e
STATE OF FLORIDA
OF
COUNTY OF
COUNTY
The for oing instru nt was acknowledged fore me
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day Se 20 bb��
The forgoi g instrumen sac nowledgeefore me
,
this day of i 20 by
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Name of person making statement.
Name of person making statement.
Personally Known L / OR Produced Identification
Type of Identification L HERNANDEZ
Personally Known
,:R �' MARIO L HERNN6EZ
Type of Identification ••'
Produced ' 1"Y• MAR
# 9
Produced =• •= MY COMMISSION # GG066499
MY OMMISSION
26 20�
EXPIRES January-y
;+ EXPIRES anuary 26, 2021
(Signature of Notary Public- State Florida)
(Signature of Notary Public- State of Florida )j
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Commission No. 4'Gl� Y (Seal)
/,,
Commission No. G-�"�'� 1// `z (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19