HomeMy WebLinkAboutBuilding Permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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Name Kenneth Porter -
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft. 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential .X
PERMIT APPLICATION FOR: Plumbing
Address: 6715 Sinsonte Court Fort Pierce, FL 34951
Legal Description: Spanish Lakes
Property Tax ID #:
Site Plan Name:
Project Name: Kenneth Porter
Setbacks Front Back:
Right Side:
Install customer supplied 30 gallon water heater
Lot No.
Block No.
Left Side:
HVAC
❑ Gas Tank
Name Kenneth Porter -
❑Gas
Piping
Company: First Quality Plumbing
❑
Shutters
City: Orange City State: FL
Zip Code: 32763 Fax: 321-610-3919
Phone No. 321-253-3939
Windows/Doors
❑ Electric
121
Plumbing
❑Sprinklers
❑
Generator
Roof
=
Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $
SFt. of First Floor: _
Utilities:Sewer ❑Septic
Building Height:
OWNERAESSEE:''
CONTRACTOR:
Name Kenneth Porter -
Name: Gary W. Evers
Address: 6715 Sinsonte Court
Company: First Quality Plumbing
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No. 772-579-6433
Address: 746 N. Volusia Ave
City: Orange City State: FL
Zip Code: 32763 Fax: 321-610-3919
Phone No. 321-253-3939
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: palmbayservice@fgplumbing.com
State or County License: CFC050566
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
OF FLORIDA/
Address:
OF z
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Personally Known OR Produced Identification
Address:
Type of Identification
Produced
City:
City:
Zip: Phone:
( ign ture of tary Public- State of Florid )
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 property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Rev. 8/2/17
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDASTATE
COUNTY OF SEACOUNTY
OF FLORIDA/
OF z
The fo��oing instrument was acknowledged before me
The forging instrument was acknowledged before me
this(„�dayof 20%by
this(`dayof /7"76')[-i 20Gjby
Name of person making statement
x
N me of person aking statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Produced1 L i'(a�fo'S((� 3j•yj(.(}
Type of Identification
Produced
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(Sign ture of Notary Public- S tetff ri N Pubacsmte dFwb.
( ign ture of tary Public- State of Florid )
J Moore
♦r AL1utincla
200864
Commission No. al(le ws� 14410 J�o2r 023
mmission No. '� No4ry, R'�s�Mar
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17