HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1.20.2020
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 Number:
Building Permit Application
Commercial Residential xxx
PERMIT TYPE: Plumbing -Water Heater
PROPOSED IMPROVEMENT LOCATION:
Address: 1278 Nettles Blvd
Property Tax ID #-. 4502.501.1456.000.5
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Install a Tempra 20B Electric Tankless
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
T Gas Piping
Sprinklers
Shutters
Generator
Sq. Ft. of First Floor: _
Lot No.
Block No.
Windows/Doors
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Christopher Burgess
Name: JOSEPH DURAN
Address: 1278 Nettles Blvd
City: Jensen Beach State:
Zip Code: 34957 Fax:
Phone No.
Company: First Choice Plumbing Solutions
Address:1687 SW MACEDO BLVD
City: FORT 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 hrstchoiceplumbingsolutions@gmail.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.
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: Y ;NTS
R (LURE TO RECORD A NOTICE OF COMMENCEMENT'�A , RESULT IN YOUR PAYING
TWICE FOR IMPROVE TO YOUR PROPERTY. A NOTICE OF COMMENCEMT MUST BE RECORDED AND
POSTED ON THE JOB E BE FIRST INSPECTION. IF YOU INTEND TO O AIN FINANCING, CONSULT
WITH YOUR LENDER OR TTORNEY BEFORE RECORDING YOUR NOTIJEE OF COMM EMENT."
Signature of Owner/ see/Co ractor as A ent for Owner
Signature of ntract tense Holder
STATE OF FLO IDA
STATE OF ORIDA
COUNTY OF
COUNTY OF
The f going instr ent s acknowledged before me
The forgoing instrument was ackn wledged before me
this day off •. v�\,�c ` 2D4L� by
this day of +„Lc . 20 C Y
���_ . � � � <- :r�-1
<-� _� L:�.r• c ,� r•1
Name of person making statement.
._ _mac,
Name of person making statement.
A
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Pro uced
Produced
(Signature of
( ignature of N i� !3 r� a)
1_ STATE OF FLO
Commission N --,.. '. eal)
-STATE OF FLORID
Commission ( o {Seal)
G 1859'f�4
El '3��'• Expires 2/14/2022
4-G 1859 l 4
91 � Expires 2/14/2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 1