HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/04/2021 Permit Number: 0�
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Building Permit Application
Planning and development Services -
Building and code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 4205 N Al Fort Pierce, FL 34949
Property Tax ID#: 1423-120-0014-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK;
Replace electric water heater40 gals in laundry room
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:$ 1065,00 Utilities: —Sewer —Septic Building Height:
OWN ER/LESStE CONTRACTOR:
Name Kevin Liske Name:Anthony Fioretto
Address:4205 N A1A Company:duality Plumbing &Drains
City: Ft Pierce State:_ Address:PO Box 1466
Zip Code: 34949 Fax: City; Port Salerno State:FL
Phone No.757-508-7160 Zip Code: 34992 Fax:
E-Mail:kevin.liske@hotmail.com Phone N0772-220-7577
Fill in fee simple Title Holder on next page(if different E-Mail info@gpd.plumbing
from the Owner listed above) State or County License CFC1430284
If value of construction is 2500 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.
I
SUPPLEMENTAL CONSTRUCTION LIEN LAW IN:FORMATIO4.
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.
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 our Notice of Commencement.
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Signature of Owner/ essee/Contractor as Agent for Owner 5 nature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDAa
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COUNTY OF C COUNTY OF w�LLL
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Not rization
this day'of 202b by this day of 2020�by
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Name of person making stat nt. Name of person making stater(dnt.
Personally Known OR Produced Identification Personally Known OR Produced Identifica✓n
Type of Identification Type of Id "on
Prod cE,D Produced
ELLEN VAUGH '; =5ta Flnri
�'a �� Commis da-Notary Public
(Signature o No fa U t G 2ioo�s c (Signat 80A% 9ry P ' Osurtisafifil@rj�� s
ctober 22, 2� 2
MY Commission Expires
Commission No. - ctobe 2022 "` °'" `:--
Commission No.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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