HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO 1MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I- lf1 �V� Permit Number: 1 L"O'
REC_
Building Permit Application NOV 0 6 /61:9
Planning and Development Services ST. Lucie County, Permituno
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERM ITTYPE:PLUMBING
PROPOSED IM,FROVEME„NT LOCATIO,.N” „ uM , m a",
Address: 3703 Avenue M, Ft Pierce Florida
Property Tax ID#: 2405-601-0532-000-2 Lot No.8
Site Plan Name: Block No. 29
Project Name:
DETAILED DESCRIPTION OFWORKx, x
Replacement of existing electric water heater with new 40 gallon electric water heater.
CONSTR.UCTo 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:$ 1000.00 Utilities: —Sewer —Septic Building Height:
OWNERJLESSEE b .,r ;,x CONTRArl'OR:
NameMARGE ALLEN Name:Lucien Rizio
Address:3703 AVENUE M Company:IRC LEAK DETECTION AND PLUMBING INC.
City: FT PIERCE, FL State:_ Address:735 COMMERCE CENTER DRIVE SUITE F
Zip Code: 34947 Fax: City: SEBASTIAN State:FL
Phone No. Zip Code: 32958 Fax:
E-Mail: Phone No 7726963747
Fill in fee simple Title Holder on next page(if different E-Mail696DRIP@ATT.NET
from the Owner listed above) State or County LicenseCFCA20364
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 "' ,. y
m b 3b:+b.r 54 MI aN# x tY9ral�' � f. ar
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
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 theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or andcovenantsthat 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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTXE OF COMMENCEMENT."
41
Signe ure_af wner see/Contractor as Agent for Owner Signa a of Co actor/Li se Holder
STATE OF FLORIDA STATE OF FLORIDA
CO U NTY OF INDIAN RIVER CO U NTY OF INDIAN RIVER
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 6 day of NOVEMBER 20JI by this 6 day of NOVEMBER 20 l q by
LUCIEN RIZIO LUCIEN RIZIO
Name of person making statement. Name of person making statement.
Personally Known x O Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
l ��J'•., VANESSAMCFALL produced VANESSAMCFALL
Produced
j; Notary Public—State o'Florida _'_ Notary Public—State of Florida
=_ + •= Commission.t GG 171744 '= Commission#GG 170744
% My Comm.Expires Jan 20.202
+,� ' ted,:My Comm.Expires Jan 20.2022 Sonded:hrough National NotaryAssr.
_aWaEMded hroyghNaicra Voar,Ass:
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida )
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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