HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/07/2021
O
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone. (772) 462-1553 Fax: (772) 462-1578
Commercial Residential X
PERMIT APPLICATION FOR:PLUMBING
PROPOSED IMPROVEMENT LOCATION:
Address. 12772 NW MARINER CT
Property Tax ID #: 4425-603-0010-000-1
Site Plan Name: HARBOUR RIDGE -PLAT4-TRACT C Lot No.—
Project Name:
12772 NW MARINER CT Block No.
DETAILED DESCRIPTION OF WORK:
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 A Plumbing _ Sprinklers — Generator � Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 11,590.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameSUSAN ROWLAND KLEIN Name:ROBERT LUDLUM
Address: 12772 NW MARINER CT Company:AQUA DIMENSIONS PLUMBING SERVICE*
City: PALM CITY State: ` Address-,1651 SW SOUTH MACEDO BLVD
Zip Code: 34990 Fax: City: PORT ST LUCIE State: FL
Phone No.772-344-8433 Zip Code: 34990 Fax: 772-343-7418
E-Mail:ADPS@AQUADIMENSIONS.COM phone N o 772-344-8433
Fill in fee simple Title Holder on next page ( if different E-MaiIADPS@A QUADIMENSIONS,COM
from the Owner listed above) State or County LicenseCFC057526
If vacua of cnnetriirtinn is ,irnn -, — ocr^nnen ■t:__ _Z
---- - - - --- - -.- v-ul 11 CJ MCI I1=1IL 130 ICqu IreQ.
If value of HAVC.is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ' Nat Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
/-Ip: Phone:
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
-
BONDING COMPANY:
Name:
Add ress:
City.
Zip: Phone:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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. you intend to obtain financing, consult
with lender or an attorney before commencing work or recor our Noti of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner ignature of tra tar i -rise 61der
STATE OF FLORI A
COUNTY OF
54- Loc i r
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this I � day of rti c 2024 by /
ivame of person making statement.
Personally Known OR Produced Identification
Type of enti (cation
Produ
(Signature of Notary Public- State of Florida )
rr ZARYgss LISA LESTER
Commission No�� Q7) �%a (° OTARY PUBLIC -STATE OF FLORIDA
r Comm# GG127647
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
STATE OF FLORIDA
COUNTY OFST rUCie
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
this 07 day of JANUARY2021 2020 by
ROBERTLUDLUM
Name of person making statement.
Personally Known X OR Produced Identification
Type o dentification
Prod d
J Y L✓ l ICA 1 �LT1
Signature of No�GG�127647
y Public- St NOTARY PUBLIC
STATE OF FLORIDA
Commission No. z' fa ($M+ GG127647
�NCF 19 6 Expires 7/24/2021
SUPERVISOR I PLANS VEGETATION I SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW