HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/14/20 Permit Number:
ST. nallce E
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential X
PERMIT APPLICATION FOR: GAS PIPING
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Y • � �I .',ft � � 11., � I i ,. '(N ` } � { t f , i. � tk � IC 121t 47 i
PRPOSED'IMP`ROVEMENT LOCATION:, ;at r=ff k ,, ;
Address: 5340 DUNN RD.
Property Tax ID #: 3403-502-0209-100-3
Site Plan Name:
Project Name:
INSTALL GAS PIPING FOR NEW NATURAL GAS APPLIANCES
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 1000.00
Name LLOYD D. RILEY
Address: 5340 DUNN RD.
City: FT. PIERCE State:
Zip Code: 34981 Fax:
Phone No. 772-521-1416
E-Mail:
Sq. Ft. of First Floor:
Windows/Doors
Roof
Lot No._
Block No.
Utilities: —Sewer _ Septic Building Height:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Pond
Pitch
Name: CHRIS JOHNSON
Company: CNJ PLUMBING L.L.C.
Address.1701 S. 37TH ST.
City: FT. PIERCE State: FL
Zip Code: 34947 Fax:
Phone No 772-801-3073
E-Mail CHRISJOHNSON@FPUA.COM
State or County License 30950
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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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 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or2n attornev before commencing work or recording vour Notice of Commencement.
Signa ure of Owner/ Lessee/Con ractor as Agent for Owner
Sign ture of Contractor/License Hofffer
STATE OF FLORIDA
STATE OF FLORIDA ,
COUNTY OF S�_ ,� f f COUNTY
OF
Swor to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Ph _ical Presence or Online Notarization
this day of ( , 2020 by
V� Phy5ical Presence or Online Notarization
this day of 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known -�' OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
J.
W.,IA,4
(Signature of Notary Public- Sta
nature of Notary Public- g.p ..,;• on a
�p�• oe MARTHA A KERR
:o�pRY.,pU ., MARTHAA KERB
Commission No. �G,3 I =?: 1�•..SeM)ary Public - State of Flo
'q
':°; s��•Lc°, Notary Public - State of Florida
mission No.66 _3/l01 , 'e ( 1i�sion N GG 311213
2023
Id
q` ,�, Commission a GG 31121
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Q�Q4. .My Comm. Expires Mar 22,
aF fl°' My Comm. Expires Mar 22,
2 Bonded through National Notary Assn.
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Rev. 5/b/20