HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number;` =11 -
4 - igo
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34952 %
Phone: (772)462-15S3 Fax: (772)462-1578 Commercial Residential
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PERMIT TYPE i
•mater Maln
I PROPOSED IMPROVEMENT LOCATION.
Address: 10920 Pine Creek Lane, Port Saint Lucie, FI. 34986 —
Property Tax ID#: 3321-501-0041-000-2 Lot No.- 41
Site Pian Name: Block No.
Project Name: - —
DETAILED DESCRIPTION OF WORI<�
r u'l 1' pex pipe from the new meter box down by the toad to the 3/4"copper water main entering the house around back _
Customer will continue to use pump system for irrigation.
CONSTRUrCT!ON INFORMATION:
Additional work to be performed under this permit-check all that apply:
_-Mechanical _Gas Tank Gas Piping —Shutters —Windows/Doors
a _Electric Plumbing —Sprinklers —Generator — Roof v Pitch
t
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ 1,200_00 Utilities: _Sewer Septic Building Height: _
OWNER/LESSEE. CONTRACTOR:
I lNameFanda Chowdhury —__ _ Name:Gregory Bassett — -- -.----
; Address:10920 Pine Creek Lane Cornpany;Wellworth Plumbing LLC
City: fort Saint Lucie State: V.L- Address:2789 Devine Road ----
-�- _ Fort Pierce a FI ----
Zap Code: 34986 Fax: _ City: -_--__.-- State:_I
g° Phone NO. 593 4534 Zip Code: 34981 Fax: _—
E-Mail:fanda028(0- aol.com Phone No(772) 579-2462
j Fill in fee simple Title Holder on next page( if different E-Mail wellworthplumbinglic@aol.com
from the Owner tilted above) State or County LicenseCFC1428815
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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Address: - - __ __- Address:
City- ___—_..w State tarty:
Zip: Phone _ I Phone P�
FEE SIMPLE TITLE HOLDER _ Not Applicable BONDING COMPANY: Not Applici'610
Name_ Narne:�--__
Address: Address
Cat City'
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E Ifs: Phone: Zip: Phone:
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I OWER/CONTRACTOR AFFIDVIT: Application is hereby made to obtaina permit to ci.., it%,, '"tallation.i%indi(oll d
I cerci 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 IIIc, the structurt,
which is fn conflict with any applicable Home Owners Association rules,bylaws or and covenai:ti prohibit .irt,h
structure.Please consult with your Home Owners Association and review your deed for any rte � � I1101 'y apply
In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,perform the wink
i 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 additiow,,
accessory structures;swimming pools,fences,walls,signs,screen rooms and accessory uses to another non (e%idential ii ry
"WARNING TOO ER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYINf
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,"
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S;¢mature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
l STATE OF FLORIDA STATE OF FLORIDA y
COUNTY OF )I�!( ,_ COUNTY
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of_fY ,l 20 Eby this day of �lC.ti� _ 20--- !'!by
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Name of person making statement. Name of pe son m ing statement,
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identifica n Type of Identification
Produced Qy�na D�•ei'8
Slate ef Florida Produce 5J Dyana Peralta ;
Pel• Cammiss;on Expires tOt'201202 Mato ai Florida
Coiwission No.GG 40081CNX L-elAy�tltRltSSi�{�rpires i9 tWVrA$jont4W4U1
!Signature f Nota Public-State of Florida ) { i nature o Notaryblit-State of Florida)
,lommission No.��11 1 (Seal) Commission Na. (Seal)
REVIEWS i FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVES
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
GATE -
1 �LCEIVED
COMPLETED
1
i
PAID RECEIPT
UTILITY HOOK-UP INVOICE
LOT: 41 DATE: 5-11-20
AREA: Sabal Creek CK# : 509
CUSTOMER: Farida Chowdhury
ADDRESS : 10920 Pine Creek Lane
1" Meter & Installation $ 411 . 00
TOTAL $ 411 . 00
Please make your checks payable to Reserve Community Development
District and mail it to 2160 Reserve Park Trace, Port St . Lucie,
Fl 34986 .
Effective 1-1-04