HomeMy WebLinkAboutOuimet Permit AppAll APPLICABLE iNF9 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
l a ct p Permit Number:
p Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1579
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 126 N Las Olas Dr
Property Tax ID #: 4511-500-0022-000-6 Lot No.
Site Plan Name: BEACH CLUB COLONY -SECTION ONE WLY 45.63 FT OF LOT 11 (OR 3566-721; 3569-2160) Block No.
Project Name: Water Heater
DETAILED DESCRIPTION OF WORK:
Installed new RUUD 40 Gallon Electric Water with expansion tank
New Electrical Meter Second Electrical Mete
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical Gas Tank —Gas Piping _ Shutters Windows/Doors Pond
Electric V/ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 900.00 Utilities: Sewer —Septic Building Height:
OWNERAESSEE: CONTRACTOR:
NameSylvain Ouimet Name: Lonnie Culbertson
Address: 2087 Boul du Roi-Charles5aint Jerome , QC Company: Jensen Beach Plumbing Inc
City: CANADA State: Address: 1086 NE Industrial BIV
Zip Code: J5L 1S3 Fax: City: Jensen Beach State:FL
Phone No. 514-602-9849 Zip Cade:
34957 Fax:772-2256779
E-Mail: sylvain_ouimetfcga@yahoo.com Phone No 772-225-6600
Fill in fee simple Title Holder on next page ( if different E-Mail peggy@iensenbeachpiumbing.com
from the Owner listed above)
State or County License 24654IRP11067372
If value of construction is 25W 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.
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 TITLEHOLDER:
— Nat Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is nereoy made to obtain a PUi1111L .V uu « = vYti a, �„� .�• �-
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 le.[a.cLer or an attorney before commencing work or recording our. Noti f Commencement.
as Agent for Owner Signature of Contractor/License Holder
STATE OF ORIDA STATE OF FLORIDA
COUNTY F_,n)a ?.�Arl COUNTY OF �� n
Swor to (or affirmed) and subscribed before me of Swor o (or affirmed) and subscribed before me of
�hysical Presence or Online Notarization _ Physical Presence or Online Notarization
this —'I day of Q n e 2020 by this 2 %L day of _ e 2020 by
Name 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 C] Q Produced
ii
1�4
ure of No y Public- Stateof Florida(Si 11of Note Pu li -
1 Florida Ott ► Nowary Public State of Florida
Public Vl Commission N Y MY n F Wilsoeai} 5464
Commission N r Rotary i 7
a4 JaGiyn F Wilson Gommission GG 2
Niy CommI5510n GG 275464 s 1110&2022
E pines ur n
REVIEWS Of R ISOR PLANS VE TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED