HomeMy WebLinkAboutBuilding Permit Application ,I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/21/2017 Permit Number: 10 AA"'0 5�
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RECEI''-D APR 9 ? 37
Building Pelrmr 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: To Select from dropbox, click arrow at the end of line
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P,ROPOSED:lMPRQI/EMEIUT I.QCATIQN
Address: 31 La Villa Way, Ft Pierce, Florida 34951
Legal Description: Spanish Lakes Country Club Community
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Property Tax ID#: 1301-111-0001-000-5 Lot No.
Site Plan Name: Block No. i
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF WORK
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Install gas line to stove
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C NSTRUIJ.l INFORMATION-
Additional work to a er orme un er this permit—check a apply:
11HVAC Ei Gas Tank Gas Piping _Shutters Q Windows/Doors
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Electric El Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 1800 Utilities: Sewer Septic Building Height:
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OWNER LESSEE CON2TRACTOR
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Name Don McClure Name: Wade D Case j
Address:31 La Villa Way Company: Lindquist Plumbing&Supply, Co., Inc.
City: Ft Pierce State:FL Address: 3185 Sneed Road
Zip Code: 34951 Fax: City: Ft Pierce State:FL
Phone No.651-470-6939 Zip Code: 34945 Fax:
E-Mail: Phone No. 772-461-1969 I
Fill in fee simple Title Holder on next page(if different E-Mail: Lindquistplumbingcompany@Gmail.com
from the Owner listed above) State or County License: CFC1428458
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUP_tEIUIENTA` GU;NSTRt.I CTIpN LIEN LAVA 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:
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobske
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.
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Signature of Owner Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
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STATE OF FLORIDA // STATE OF FLORIDA
COUNTY OF Ll�Gl C'vv���y COUNTY OF 1•e
The forgoing instrurnent was a knowledged before me The forgoing instrument was acknowledged before me
this day of 20 aby this day of 20 by
(Name of person acknowledging) (Name of person acknowledging)
(Sigilature of Notary Public-State of lorida) (Signature of Notary Pub ic-Slate of Florida
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Personally Known ✓ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
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Commission No. (Se MICH LiEn"d1i rho. (Seal) !,
MY COMMISSION#GG055253 !,
-V.
Revised 07/15/2014
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE I
INITIALS
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