HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12.30.19
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 5415 Davis Street
Property Tax ID #: 3409.501.0048.000.0
Site Plan Name:
Project Name:
Permit Number:
Building Permit Application
Commercial Residential xxx
Lot No.
Block No_
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE, REMOVE AND INSTALL NEW 50 GALLON ELECTRIC WATER HEATER FROM GARAGE
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical
Electric
Total Sq. Ft of Construction:
Cost of Construction: $ 800
Gas Tank
Plumbing
Gas Piping
— Sprinklers
Shutters'"(
Generator
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
Windows/Doors
Roof Pitch
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name William Green
Name: JOSEPH DURAN
Address: 5415 Davis St
Company: First Choice Plumbing Solutions
City: FORT PIERCE State:
Zip Code: 34982 Fax:
Phone No.
Address: 1687 SW MACEDO BLVD
City: PORT SAINT LUCIE State: FL
Zip Code: 34984 Fax:
Phone No 772-879-1414
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail firstchoiceplumbingsolutions@gmaii.com
State or County License CFC1427369
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.
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- OUR FAILURE TO RECORD A NOTICE OF COMMENCEM T MAY RESULT IN YOUR PAYING
TWICE FOR IMPRO ENTS TO R PROPERTY. A NOTICE OF COMMEN ME ST BE RECORDED AND
POSTED ON THE JOB IT FORE THE FIRST INSPECTION. IF YOU INTEND BTAIN FINANCING, CONSULT
WITH YOUR LENDER O ATTORNEY BEFORE RECORDING YOUR IyOTICE C MENCEMENT."
Signature of O er/ esse Contracto as Agent for Owner
Signature Cont ctor/L
nse H der
STATE OF F RIDA
STATE OF LOR DA
COUNTY OF :_- �. ''_
COUNTY O `-)
The forgoing instrument was acknowledged before me
The forgoing instrument was
acknowledged before me
this �day of +' ..` :- t . 20'i c\ by
this ! day of
X)c , 20 �` by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced identification
Personally Known.
OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Not - o I
(Signature of Notary P ai�tW1Rol�&f P ' no
TARP PUBLIC
S STATE OF
NOTARY PUBLIC
Commission No.� F �q
Commission No.
—STATEOF(SbQ0IDA
orr. GG18 914
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Comm* GG185914
Expires 2114/2022
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19