HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/29/20
Permit Number:
91ro
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WORE-
BuildingPermit 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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PR P. i h t rr
O OSE,D IIVIPROUEMENT LOCATION
I. I
Address: 2711 S 19TH ST.
Property Tax ID #: 2421-243-0001-000-3
Site Plan Name:
Project Name:
INSTALL NEW GAS PIPING FOR NEW 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 Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1000.00 Utilities: _ Sewer _ Septic
Lot No.
Block No. _
Building Height:
Pond
Pitch
OWNER/LESSEE:'CONTRACTOR:y#
,
$II,
Name MANSUETA D. CROWELL
Name: CHRIS JOHNSON
Address: 2711 S. 19TH ST.
Company: CNJ PLUMBING LLC.
City: FT. PIERCE State:
Address: 1701 S 37TH ST.
Zip Code: 34982 Fax:
City: FT. PIERCE - State: FL
Phone No. 316-249-2749
Zip Code: 34947 Fax:
E-Mail:
Phone No 772-801-3073
Fill in fee simple Title Holder on next page ( if different
E-Mail CHRISJOHNSON@FPUA.COM
from the Owner listed above)
State or County License 30950
it value or construction is cSuu or more, a KMUKMU Notice of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable
Name:_
Address:
City:
Zip:
Phone
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
Citv:
Zip: Phone:_
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:.
Not Applicable
State:
BONDING COMPANY: Not Applicable
Narne:_
Address:
City:
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 IPnrlPr nr an attnrnev hefore commgucinia work or recording vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor ent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA�,, `
11
COUNTY OF ��C . L.U(',%.�.
COUNTY OF �T.
Swor o (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Ph sical Presence or Online Notarization
✓Physical Presence or Online Notarization
this f `day of 1)e ,r 12020 by
this?4day of d c+o1nP,r , 2020 by
Name of person making statement.
Name of person makingstatement.
Personally Known OR Produced Identification
Personally Known V'/OR Produced Identification
Type of Identification
��.
Type of Identification
�.d•
Produced
Y &4
Produced
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(Signature of Notary Public- State of C
'':
ISi nature of Notary Public- State c;• KOW
Comm.#GG986
°•�' • Comm.#GG9
Commission No. C G C1 SCD 600 ��. i
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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. 5/6/20