HomeMy WebLinkAboutFalter SLC permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 04/2/2020 Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 452-1578
Building Permit Application
Commercial Residential X
PERMIT TYPE: plumbing - Remodel
PROPOSED IMPROVEMENT LOCATION:
Address: 10410S Ocean Dr Unit 303
Property Tax ID #: Y5-11 / Jr/v 0012 000 6 Lot No._
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Install shower valve in guest bath. Install pre -sloped floor and shower pan. Install new drain (Same Location).
CONSTRUCTION INFORMATION:
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: $ 1300? 02 Utilities: -Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Charles Falter
Name: Dale Hammond
Address: 10410 S Ocean Dr Unit 303
Company: For Him Plumbing
City: Jensen Beach State:
Address: PO Box 1355
_
Zip Code: 34957 Fax:
City: Jensen Beach State: FL
Phone No.
Zip Code: 34957 Fax:
E -Mail:
Phone No 772-342-8677
Fila in fee simple Title Holder on next page ( if different
E -Mail forHimplumbing@aol.com
from the Owner listed above)
State or County License CFC1428915
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 MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY:
Name: 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: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTti. Gi-•–
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU ICr'T'UWi
WITH YOUR LENDER OR AN PfTORNEY BEFORE RECORDING Y OTICE OF COMMEJ CE ENT."
Signature of owner/
as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLORIDA L' STATE OF FLORID
COUNTY OF �-✓T '� COUNTY OF
The for�ng instrum nt wa acknowledged before me
is day of / � 20 -
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Name of person making statement -
Personally Known OR Produced Identification
T en r rca
Produced — r,
(Signature of Notary Ptr
Commission No. 6
REVIEWSI FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19
The for, Wog instrum t was cknowledged before me
t ' may of ��� 202�-�y
momi
Name of person making statement.
Personal) i I OR Produced identification
TypEFo-f Identification
. €,s"-NUM*9 Public • State of Floridi JSignature of Notary Public-
Commission # GG 24467
0 My(��ia Expires Aug 25, 20 ommisslon No. [� 7'
*P BOnded Through National Notary As _
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ROEVIEW I S REVIIEWPERVISOR I RE EW V EVIEWON
WALTER d PAYNE If
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mission # GG 244
My Comm Expires Aug 25,
REVIEW I REVIEW
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