HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ''rr
Date:�`f 13 Za Z r Permit Number: - �W` — 2d(a
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
.PROPOSE6'IIVIPROVEMENT LOCATi3O.N._
Address: 8418 Belfry PI Port St Lucie, FL 34986
Property Tax ID#: 3327-701-0018-0004 Lot No,
Site Plan Name: Block No.
Project-Name;
{DfTAifQ DESCRIPTION OF WORX r'
Replace electric Water Heater in garage 50 gals
New Electrical Meter Second Electrical Meter
CQNSTRUCT!°ON INFORNlATlON
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: $ d0 d Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: = CONTRACTOR
Name George J Townley Name:Anthony Fioretto
Address:8414 Belfry PI Company: Quality Plumbing &Drains
City: Port St Lucie State:FL Address: PO Box 1466
Zip Code: 34986 Fax: City: Port Salerno State:FL
Phone No.206-484-8757 Zip Code: 34992 Fax:
E-Mail: Phone N0772-220-7577
Fill in fee simple Title Holder on next page(if different E-Mail info@g pd.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.
`�t1PPLE1�/IEiVTAt;'C4.�STRUCTfON�LI�EN`fJ�1N INFORMATION s r�_ � � '�,� � rn ���;2� h�;
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.
�ignature of Owner/Le see/Contractor as Agent for Owner Signature of Contractor/Licen a Holder
STATE OF FLORIDA STATE OF b—L UQ COUNTY OF FLORIDA S� LA__COUNTY OF ��`�"
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Ph sical Presence or Online Notarization Ph sical Presence or Online Notarization
this ay of + � 202�by this ay of 202b
Name of person making stAkment. Name of person making statem , t.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identific on Type of d Identifica�' /
Produce Produced ( l
(Signature of Notary Publi ate of Florida) (Signature of Notary Public-State of Florida)
Commissi RYP�, VAU Commissi
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of Florida-Notary Public � , �`�_S CLLLN tate of FloridaA��G_
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AMP res ANGROVE
COUNTER RE EW REVIEW REVI REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 20