HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO M T BE COMPLETED FOR APPLICATION TO BE ACCEPTED )(�
Date: �� I Permit Number: l-/ 0
Building Permit Applic tion Nov -6 2019
Planning and Development Services
Building and Code Regulation Division Permitting Departmen
2300 Virginia Avenue,Fort Pierce FL 34982 S t. Lucie County, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial esidential
PERMIT TYPE:Plumbing
Address: 2102 Nettles Blvd Jensen Beach, FL 34957
Property Tax ID#: 4502-501-0105-000-7 Lot No.
Site Plan Name: Block No.
Project Name: Perhach
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Remove existing tub and install new walk in tub No tile or dry wall work being done
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Additional work to be performed under this permit–check all that apply:
_Mechanical Gas Ta k _Gas Piping _Shutters _Windows/Doors
Electric _ ISP umbing _Sprinklers Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 1700.00 Utilities: —Sewer —Septic Building Height:
NameAndrew J Perhach Name:Michael Coleman
Address:2102 NETTLES BLVD Company:Prefab Plumbing Inc
City: Jensen Beach, State: Address:1100 Carr St
Zip Code: 34957 Fax: City: Palakta State:FL
Phone No.772-229-3022 Zip Code: 32177 Fax:
E-Mail: Phone N0386-546-7643
Fill in fee simple Title Holder on next page(if different E-Mail mgc1980@gmail.com
from the Owner listed above) State or County License CFC043003
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 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 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,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 N ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature of Owner/Lessee/Co tractor as Agent for Owner Signature of Contractor/License Holder
STATE OF COUNTY OF ORIDA/� COUNTY OFT
STATE OF Af��� l�ZiA
The fo ing instrument was acknowledge efore me The forgoing instrume t was acknowledge efore me
this day of 20 P-M this!7 day of 20 by
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Name of person making statement. Name of person making statement.
Personally K n Produced Identification Personally Known '�""OR Produced Identification
Type of Id tificati n Type of Id
Produced Produce
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Signatu of of ub ic-State of Florida I (Signature lic-State of Flori a
Commissio No. 0 "x'4 Not c state or Florida av�'vo Noc�ry Pu of Fiorids
p(q POCKER Commission No. ' KATHRVKER
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEAT R L
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
iev.2/7/19