HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
COUNTY
F L 0 R I D A
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 452-1578
Permit Number:
Building Permit Application
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:.
Address: 6 Lake Vista Trail 6-105
Property Tax ID #: 3422-500-0075-000-6
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Commercial Residential x
Lot No.
Block No.
Install 30 gallon Low boy water heater under A1C Air handeler in closet. , E Le m U) 4EOkE
CONSTRUCTION INFORMATION:
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: $ Utilities: _ Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
NameLinda Gaskill
Name: Lonnie Culbertson
Address:698 SE Prineville St
Company -.Jensen Beach Plumbing
City: Port Saint Luice State: `
Zip Code: 34983 Fax:
Phone No. 772-528-6704
Address: 1086 NE Industrial Blvd
City: Jensen Beach State: FL
Zip Code: 34957 Fax: 225-6779
Phone No772-225-6600
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail Jackie@jensenbeachplumbing.com
State or County License RF11067372 1 24654
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 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.
I n 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,
ignature of
as Agent for Owner ature of Contract&4Liee�se H
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF n,1 0 �COUNTYOF a ►2
The forgoing instrument was acknowledged before me
this 9 day of October , 20ja by
LonnEL Culbertson
Name of person making statement.
Personally Known xx OR Produced Identification _
Type of Identification
Produced
(ig ature of Wary Public- SrJarY Pµblicstate c
` Jac1y� Ws44nn GG
Commission No. GG 19 -7(SV61¢
Expires i 110812022
aw
The forgoing instrument was acknowledged before me
this s day of OCA b g , 20_6 by
Lonnie Culbertson
Name of person making statement.
Personally Known xx OR Produced Identification
Type of Identification
Produced
�*re of Notlary Public- State of Florida
ota Public State at
mission No X75 (W F Wilson
Fxo re 110812022
REVIEWS
FRONT ZONING
SUPERVISOR
PLANS
VEGETATION
SIVIU�RTLE
MANGROVE
COUNTER REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Cv. LJ /J 17