HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-I578 Commercial Residential
PERMIT APPLICATION FOR: Plumbing WATER HEATER
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Address: 9004 Pumpkin Ridge RD, PSL 34986
Legal Description: MAIDSTONE PB 43-11 LOT 136 OR 3505-1586
Property Tax lD#: 3322-505-0145-000-6 Lot No. 136.-_.._._
Site Plan Name: Block No.
Project Name: SIMIELE WATER HEATER
Setbacks Front Sack: Right Side: Left Side:
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REPLACE 50 GALLON TALL ELECTRIC WATER HEATER
77
Additional work to e e nrme under this permit—c ec a apply:
[n
I]HVAC 13 Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
11 Electric IXI Plumbing 05prinklers ❑Generator Roof Roof pitch
Total Sq. Ft of Construction: 5 Ft. lo
of First
Cost of Construction:$ 600.00 Utilities:ll Sewer L_septic Building Height:
x
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...CO.NT � :-.... ...
Name MARK SIMIELE Name: RONALD E MEEKS
Address: 3321 READING RD Company: MEEKS PLUMBING INC
City: WTKINS GLEN state: NY Address: 5555 US HWY 1,SUITE 1
Zip Code: 14891 Fax: City: VERO BEACH State: FL
Phone No. 607-227-4541 Zip Code: 32967 Fax. 772-569-7647
E-Mail: Phone No. 772-569-2285
Fill in fee simple Title Holder on next page(if different E-Mail: INFO@MEEKSPLUMBING.COM
from the Owner listed above) State or County License: CFCO24535
If value of construction is$250D or more,a RECORDED Notice of Commencement is required.
5 W LEME T TIdI I'EN W INFdR1 TION
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DESIGN ER/ENGINEER. -X_ Not Applicable MORTGAGE COMPANY: _X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Prone:
FEE SIMPLE TITLE HOLDER: _X 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
corrymRricing work or recordin our Notice of Commence nt.
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Signa ure of Owner/Lessee/ ontractor as Agent for Owner Signature of Contractor/ icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 97 day of APRIL 202_L by this 27 day of APRIL 12021 by
RONALD E MEEKS RONALD E MEEKS
Name of per o making statement Name of p rson making statement
PersonallyKnown OR Produced Identification Personally Known OR Produced Identification
Y
Type of IdentificatioK Type of Identificati n
Produced Produced
(Sign urIm%1V
Florida} (Sig ture of otary Pub i -State of Florida)
Com issilic SW4�efflarida Corn issi No „ state i Iftaw
Thibault L t SIN auit
ssion GG 093573 ' My Commission GG o93573
1012021 1012021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17