HomeMy WebLinkAbout11001 S Indian River Drive.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1.07.2020
BMW
COUNTIY
IF D 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) 462-1578
PERMIT TYPE: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 11001 South Indian River Drive
Property Tax ID #: 3532-503-0030-000-6
Site Plan Name:
Project Name:
Permit Number:
Building Permit Application
Commercial Residential xxx
DETAILED DESCRIPTION OF WORK:
Install Propane Tankless Water Heater • EXtr 2 1 N L
[CONSTRUCTION INFORMATION:
Lot No._
Block No.
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:
Cost of Construction: $ 800
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Theresa Polhemus
Name: JOSEPH DURAN
Address: 11001 South Indian River Drive
Company: First Choice Plumbing Solutions
City: FORT PIERCE State: r-
Zip Code: Y41982_ 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 Brstchoiceplumbingsolutions@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:
Add Tess:
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 FOR7LNDIW6-R
OVEMENTS TO YOUR PROPERTY. A NOTICE OF COM ENCEMENT MUST BE RECORDED AND
POSTED ONJOB SITE BEFORE THE FIRST INSPECTION. IF YOU IN e D TO OBTAIN FINANCING, CONSULT
WITH YOUR AN ATTORNEY BEFORE RECORDING YOUR NOTICE MENCEMENT."
Signature of OWw err / ontractor as Agent for Owner
Signature ofobtracto , i en a Holder
STATE OF FLORIDA
STATE OF 1_06A.
COUNTY OF - �.uC_�—� >
COUNTYO
The forgoing instrument was acknowledged. before me
The f°�ing instrument was acknowledged before me
—
this day of Se 20 i;1, % by
this f day of ti �,L 20 9-Uay
Name of person making statement. T
Name of person making statement.
Personally Known D"OR Produced Identification
Personally Known � DR Produced Identification
T
Type of identification
Type of Identification
Produced
Produced
I
Ariana Veneziano' f , .
(Signature 4 LftTAft)6orida y
(signature of u TaP9 a
NOTAR U
-STATE OF FLORIDA
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Commissio b ? Comm# GG185914 (Seal)
s�NCE
STATE OF FLORID
Commission (Seal)
11� Expires 211412022
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1 � F_xpirgs 2/14/2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7 19