HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:�a� \ �� Permit Number: a`ad�Ja�1�
RECEIVED
- Building Permit Application
JAN 2 9 2020
Planning and Development Services ST. i_ucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 �(
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential V
PERMITTYPE:Plumbing
PROPOSED IM .RO)/EMENT LOCATION::
Address: 144 PEPPER LN Jensen Beach FI 34957
Property Tax ID#: 4511-503-0031-000-1 Lot No.25
Site Plan Name: BAY TREE LOT 25 Block No.
Project Name: Brown
DETAfLED DES(-RIPTION_.OF WORK:,
Replace 55 gal water heater ��,-��j
"CONSTRUCTION I,NF.ORIVIATIQN:
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: Sq. Ft. of First Floor:
Cost of Construction:$ 388• Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE CONTRACTOR:
NameThomas and Sandra Brown Name:Paul Cloutier
Address:144 Pepper Lane Company:FPL Home Services
City: Jensen Beach State:_ Address:6001 Village Blvd
Zip Code: 34957 Fax: City: west palm beach State:fl
Phone No. Zip Code: 33407 Fax:
E-Mail: Phone No5617475740
Fill in fee simple Title Holder on next page(if different E-Mail desiree.pacheco@fpl.com
from the Owner listed above) State or County LicenseCFC1430331
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.
SUPPLEMI NTA'L CQNST.,RUCTION iIEN LAW INFORIVIATIO!N_.,
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 1 VE EN S TO YOUR PROPERTY. A NOTICE OF COM CEMENT MUST BE RECORDED AND
POSTED O HE O SI BEFORE THE FIRST INSPECTION. IF YO T TO OBTAIN FINANCING, CONSULT
WITH Y R LEN E R ATTORNEY BEFORE RECORDING YO NOT OMMENCEMENT."
A I//V/A
Signature of 0 ner/Lessee/Contractor as Agent for Owner Signatur of ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY 0FStLucie COUNTY OFSti.ucie
The forgoing instrument was acknowledged before me The for oing instru ent was acknowledged before me
this�day of 2006 by this �T day of Ct V:) 26aO by
Name of pers making statement. Name of pe on makingstatement.
Personally Known JZ`O`R Produced Identification Personally Known V/ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Pili at��i=Fld�i�'�qKUSSF:ATH (Signature of Notary Public-State of Florida)
=a t� MY COMMISSION#GG049347
� •,�PpY P
STEPHANIE KU
Commission No. -" •• 15A, EXPIRESWgWg nber21,2020 Commission N ';°' �TH
OMMISSION#GG049347
EXPIRES
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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