HomeMy WebLinkAboutApplication Prefab Plumbing CollinAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
WC
t- L A. Building Permit 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
PERMIT APPLICATION FOR:
PIUC71bIng
PROPOSED IMPROVEMENT LQN�
Address: 5450 Palmetto AVE Fort Pierce, FL 34982-3322
Property Tax ID #: 3409-502-0001-000-2
Site Plan Name:
Project Name: Collin
Residential X
Lot No.213
Block No.
DETAILED DESCRIPTION OF WORK:
Remove existing tub and Install New Walk in Tub. NO tile or dry wall work being done
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 Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1700.00 Utilities: —Sewer _ Septic Building Height:
OWNER%LESSEE:
CONTRACTOR:
Name Alan S Collin
Name: Michael Coleman
Address:5450 Palmetto AVE
Company: Prefab plumbing Inc
City: Ft Pierce State: f'L—
Zip Code: 34982 Fax:
Phone No.772-485-6575
Address:1100 Carr St
City: Palakta, State: FL
Zip Code: 32177 Fax:
Phone No386-546-7643
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailmgc1980@gmail.com
State or County LicenseCFC043003
Lu11�1uuLLw11 u� c:)uu or more, a Kt:LUKutu Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
----- --------- _—_ .... _.......
__-_.___-- ----_ _ _--
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: V Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
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 lender or an attorney before commencing work or recording your Notice of Commencement.
of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLOSTATE OF FLORIDA
COUNTY OF'y�� !�` ,c } Ind' �� COUNTY OF " ��� &,f_1W2 E5
Sworn to (or affirmed) and subscribed before me of ,�� Swornt (or affirmed) and subscribed before me of
Physical Presenc or Online Notarizatioi�s� P ysical Press or •online Notarizatio��
this day of byPC;,2/ this day of 2Q� by_ oa
q 14 AJ of'o 0p> t--6- m A � /
Name of person making statement. Name of person making statement.
Personally Kno OR Produced Identification Personally Kn roduced Identification
Type of Ide ification Type of Identification
Produced,/ %i/e� Prnrludari/ 1
{Signatu of p4 of Florhg N POCKER
Pub is - State of Florida
(Signatu of N r P I
Yry
f Florida HRYN PocKea
Commission No.
Nota
Com1?�ission # HH 025227Com��tt}}�ic1
;:�E`
: Notary Public •State of Florida
HH 025227
My Cprt4'res Nov 21, 2024
Commission No.or
My Comb*?�Xites Nov 2t, 2024
nded through National Notary Assn.
Bonded through National Notary Assn.
REVIEWS
FRONT ZONING SUPERVISOR
PLANS VEGETATION
SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW
REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED