HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/04/2021 pe
rmit Number•
91To[LUCE
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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;
Whole house Re-Pipe in attic&walls of fixtures,with UponorEpex pipe �,�/ ,3�� '� f/o�a C66� i o wiTO 864
u
�I2 Hoq- C oG i� !f 4e-L f-1xju,eCS o /-/a�aa t /4S 2 J3�?H�Ga�kS
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: $ 10000.00 Utilities: —Sewer _Septic Building Height:
OWNERAESSEE: - CONTRACTOR:
NameKevin Liske Name:Anthony Fioretto
Address:4205 N A1A Company:Quality 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 No772-220-7577
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.
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SUPPLEME�1TAfr G NST_RUCC1tUI LENhLAV�I INF,(?RM AT lON
i"[' F.riz Y v^J �'•+'y Yr,. S. r .g tig
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.
Signature of Owner/ essee/Contractor as Agent for Owner Sfkri5fure of Contractor/License Holder
STATE OF COUNTY OF
FLORIDA
C � " . COUNTY OF
Sworn to(or affirmed)and subscribed before me of Sworn to.(or affirmed)and subscribed before me of
ysical Presence o- Online Notarization Ph is I Presence Online Notarization
this day of 202V by this y of 202�jby
Name of person making stat nt. Name of person making stater64nt.
Personally Known OR Produced Identification Personally Known 1. OR Produced Identification
Type of Identification Type of Id onJ�—
Prod c V / Produced
,,� o_Sta Flori
Y PUml4 ELLEN VAUGFf =� �c commies da-Notary public
(Signature o No $�i i G 2ioo7 is (Signet o�, a�."ary P �S@gt�afifil�i �q S
;9 0: £ 9 tobar 22, 2� 2"ooF„oQ.' RrY Commission Expires
"— :-
Commission No. --- C--Ct°i'—F 2022 Commission No.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
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