HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/28/19 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
PERMIT TYPE: Replacing Bath Tub
PROPOSED IMPROVEMENT LOCATION:
Address: 102 Aqua Ra Drive, Jensen Beach, FI
Property Tax ID a: 4511-811-0022-000-1 Lot No. 21
Site Plan Name: Block No. A
Project Name: Nielander Bath Remodel
DETAILED DESCRIPTION OF WORK: 1
Replacing owner supplied bath tub & tub valve
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: $ 1675.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Henry Nielander
Name:William R Jenkins
Address:102 Aqua Re Dr
Company: E;lite Plumbing Solutions
City: Jensen Beach State: _
Zip Code:34957 Fax:
Phone No.772-834-2177
Address:7693 NW Ellipse Way
City: Stuart State: FL
Zip Code: 34997 Fax: 772-324-6460
Phone N0772-232-6924
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail (weaver@eliteplumbing.biz
State or County License 30084
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: x Not Applicable
Name:
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
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
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Signature
as Agent for Owner f Signature
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF HAahri ICOUNTYOFManin
The forgoing instrument was acknowledged before me I The forgoing instrument was acknowledged before me
this A day of OC.fo ber 2019 by this 29 day of oclaber 20_ by
Wi I Ilam R .Ten ki cis Wllkme R Jenkins
Name of person making statement. Name of person making statement.
Personally Known )� OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
LLFM rtrwvtx -------- _ 71LEANN WEAVER
P f.; MyCOMMISSION IGG331718 ��� MYCOMMSSIONiGli331i
Jule 17, 2023
EXPIRES:Jute 17,20 3
Tl 8adad nl Notary Pibk umenvrkom ... et• IJnd«M •, i a
(Signature of Notary Public ,State c on a (ignature of Notary Public -
Commission No.6031113 (Seal) Commission No. GG331713 (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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