HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number::X1 I - W
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial xx Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: PLUMBING
Address: 6837 S US 1, PORT ST LUCIE, FL
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name: BLOOM BEAUTY
New Electrical Meter Second Electrical Meter
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Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping
_ Electric Plumbing _ Sprinklers
Total Sq. Ft of Construction:
10 /.
NameJENNY RIOS
Address:6837 S US1
_ Shutters _ Windows/Doors _ Pond
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
City: PORT ST LUCIE State: _
Zip Code: 34982 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:LESTERJ CRAWFORD III
Company: COMMERCIAL PLUMBING INC
Address:1991 SE GIFFEN AVE
City: PORT ST LUCIE State: FL
Zip Code: 34952 Fax: 772-335-1411
Phone N0772-335-1411
E-Mail commercialplumbing@hotmail.com
State or County LicenseCF-CO57540 £-
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
Name:
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MORTGAGE COMPANY:
Name:
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_ Not Applicable
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 attornev before commencing wnrk nr rprnrdina vnIIr Kintira of rnmmanramant
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S at ure o ontractor icense Holder
Sign 11 of Own Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OFSTLUCIE
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
xx Ph Ical Presence or Online Notarization
xx Physical Preser1ce or Online Notarization
this day of _ Alay 2020 by
this jjjNay of A&v2020 by
Name of person aking statement.
Name of person making statement.
Personally Known xx OR Produced Identification
Personally Known xx OR Produced identification
Type of Identification
Type of Identification
Produced
Produced
ture of Notary Public- State
(Signature of Notary Public- State '
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Commission No. 96 N RENEEABATALINI
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#n ission No. .s �� e9l); Public • State
X GG 959
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