HomeMy WebLinkAboutBuilding Permit Application it
IF71
PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
iDate: Permit Number: 55/
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- -- --- Building Permit Application
Planning and Development Services
Building and Code Regulation Division
i 2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential X
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PERMITTYPE:SPECIALTY PERMIT
PROPOSED-IMPROVEMENT LOCATION:'
Address: 1507 EASY STREET
(Property Tax ID#: 3402-609-0725-000-0 Lot No.30
(Site Plan Name: Block No.
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Project Name: EASY STREET PROJEC-WATER INSTALL
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DETAILED DESCRIPTION OF WORK:
SET WATER METER TO EXISTING SERVICE AND RUN 1"LINE TO HOUSE AND TIE IN WITH COPPER ABOVE GROUND
LEAVING JOINTS EXPOSED FOR INSPECTION.
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Ost of Construction:$ $544.00 Utilities: —Sewer —Septic Building Height:
OWNER/L'ESSE'E: CONTRACTOR:
Name KYLE FLOYD Name:CITY OF PORT ST LUCIE UTILITY SYSTEM
Address: 1507 EASY STREET Company:
City: FORT PIERCE, FLORIDA State:_ Address:900 SE OGDEN LANE
Zip Code: 34982 Fax: City: PORT ST LUCIE State:FL
Phone No.(760)680-6675 Zip Code: 34983 Fax:
E-Mail: Phone No(772)873-6400
Fill in fee simple Title Holder on next page(if different E-Mail UTILITYWATER@CITYOFPSL.COM
from the Owner listed above) State or County License 25597
j If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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'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 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.
Iln consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
iin accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
IThe following building permit applications are exempt from undergoing a full concurrency review:room additions,
laccessory 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
must be recorded in the public records of St.
A Notice of Commencement
� improvements to your property.
Lucie County and p5ged on the jobsite before the first inspection. If you intend to obtain financing, consult
with le or an t me before commencingwork or recor ' o otice of Commencement.
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Signature of Owner Lessee/Contractor as Agent for Owner Signature of Contr for/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF St 1-1-icic COUNTY OF St T nrie
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
_Physical Presence or Online Notarization _y Physical Presence or Online Notarization
this_2___day of FPhrnary ,2020 by this_? day of FPhrnanr ,202f by
Rrad A�lacek Rrarl Marrk
Name of person making statement. Name of person making statement.
Personally Known X _OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Sign re o (Sign re
o<�'Y° -• JEANETTE THOMPSON <►AY°o''• JEANETTE THOMPSON
'?• Notary Public-State o Commissi
ff p� �: Notary Public-State of FI rt
Commission �' n a HH 62794 ". N HH 6279
'••,o°Fl My Comm.Expires Nov 12,2024 of rti•' My Comm.Expires Nov 11,2024
on
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.5/6/20