HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: a 0w • l (o
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Building Permit Application �E; �C9 �a
Planning and Development Services
8 i ilding and Code Regulation Division 0°1Ik
2300 Virginia Avenue, Fort Pierce FL 34982
Pone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PIERMIT
TYPE: Plumbing
00
IN
Address: 5700 Killarney AVE Fort Pierce, FL 34951-4801
Pro pertyTax ID #: 1301-613-0405-000-8 Lot No._
Site Plan Name: Block No.
Proiect Name: Levo
II Walk in Tub in existing Shower area NO tile or dry wall work being done
Jitional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric z1olumbing _ Sprinklers _ Generator
al Sq. Ft of Construction: _
;t of Construction: $ 1700.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
Windows/Doors
Roof Pitch
Building Height:
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NameAlbert M Levo
Name: Michael Coleman
Address:5700 Killarney AVE
Company: Prefab Plumbing Inc
City: Fort Pierce State: EZ—
Zip Code: 34951 Fax:
Phone No.607-206-8576
Address:1100 Carr St
City: Palakta State: FL
Zip Code: 32177 Fax:
Phone N0386-546-7643
ocker
E-Mail adam P @9mail.com
State or County LicenseCFC043003
E-Mail: N/A
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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SIR
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City: State:
City: State:
Z$: Phone
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I '
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I c i rtify 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 9lonsideration 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 NOTICE OF COMMENCEMENT."
. It"u-1 4!5z ram.'
Silgnature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA-
COUNTY OF�6_ ZAU)�112�
COUNTY OF �7GNV2d S
The for oing instrum pt was acknowledged before me
The forgoing instrume t was acknowledged before me
this day of 20��by
this � day of !Q A/ 20� by
Name
of person making statement.
Name of person making statement.
Personally
Known Produced Identification
Personally Known L/ stOR Produced Identification
Type
of Identifi ion
Type of Identification
Produced
Produced
Notary Public State of Florida
KATHRYN POCKER
a : f ," ve My Commission GG 049422
'$ Expires 11/21/2020
(Signature
of y - ° oe COCKER
(Signatur of tary Pu llc- " a e o on a
Commission
c ca My Commission GG 049422
No. ` or Expires 1 1a/2020
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19
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