HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
(�(
O , Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:PlumbIng
_- ----------- --
PROPOSED IMPROVEMENT LOCATION:
Address: 3724 Brocksmith Rd Fort Pierce, FL 34945-
Property Tax ID#: 2329-501-0012-000-1 Lot No.27
Site Plan Name: JAMES Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Install Walk in Tub using existing Shower area using existing Drain and P-Trap NO Tile or drywall work being done
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _ Pond
Electric _Plumbing _Sprinklers _Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1700.00 Utilities: _Sewer _Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name Gerald S James (LF EST) Name:Michael Coleman
Address:3724 S BROCKSMITH RD Company:Prefab Plumbing Inc
City: Fort Pierce State:_ Address:1100 Carr St
Zip Code: 34945 Fax: City: Palakta State:FL
Phone No.772-528-9980 Zip Code: 32177 Fax:
E-Mail: Phone No386-546-7643
Fill in fee simple Title Holder on next page( if different E-Mailmgc1980@gmail.com
from the Owner listed above) State or County LicenseCFC043003
If value of construction is 2S00 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,S00 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: 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 or an attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FL,QR DA? STATE OF FLOR!Jlt�:, (�
COUNTY OF ;'>le-0,u—)A A_t�' COUNTY OF �
Sworn�q4or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
G�_Ohysical Pres ce or Online Notarization --Phy sical Presence or Online Notarization
this day of 2020 by this v)l day of n 0 7 — .2020 by
(1-46t:2 I Co
Name of person making statement. Name of person making statement.
Personally Known OR Prod ed Identification Personally Kno Produced Identification
Type of Identificat' n Type of Iden ification
PrDcluced A Produced
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(Signature of No 'Pu ic-St gnature ol of y ubli Ud
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tir �. KATHRYN POCKER s�` °�e KATHRYN POCKER
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Commission No. `( edmmission<<HH 025227 C mmission No. `� `Y. ( e ,mission HH 025227
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 16120