HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date:
S�'Z
Ca —U to
',
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: Jan Chirp
PROPOSED IMPROVEMENT LOCATION:
Address: 5505 Deleon Ave
Property Tax ID #: 1301-614-0127-000-8
Site Plan Name:
Project Name: Jan Chim
DETAILED DESCRIPTION OF WORK:
Re pipe hot and cold water lines in house with uponor
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
Electric ✓Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: 77
Cost of Construction: $-J (J�
OWNER/LESSEE:
Name_
Address
Lot No.
Block No.
Windows/Doors _ Pond
Roof Pitch
Sq, Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
City: State:
Zip Code: Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the owner listed above)
CONTRACTOR:
Name: Wade Case
Company:
Lindquist Plumbing & Supply Co., Inc.
Address:3185 Sneed Road
City: Fort Pierce State: A
Zip Code: 34945 Fax:
Phone No 772-461-1969
E-Mail lindquistplumbinccompany@gmail.com
State or County License CFC1428458
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Not
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
Not Applicable
City: State: _
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phont
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 Count yy makes no reprelicablelHomeaOwnerstAs�oclztlonlru esabylawu orsndpcovenants that meydrestrictborprohib t such
which is .cease c with any applicable
structure. Please consult any
your Home Owners Association and review your deed for any ants that
mwhich 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/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S>-Lk,C COUNTY OF s c C1e
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or_ Online Notarization
this 5th day of May2021 , 2020 by
Sworn to (or affirmed) and subscribed before me of
—Physical Presence or_ Online Notarization
this 5th day of May 2021 , 2020 by
Wade case
watle Case
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification _
Type of Identification
Produced
nnnn
(Signature of Notary b� Stt
tsleof Florida
,yn Noary ,c��
Commission No. 'P Michelle 7.r__d H101604
y0om
REVIEWS FRONT ZONING
COUNTER I REVIEW
TE
Personally Known x OR Produced Identification
Type of Identification
i
(Signature of Not I,N`^� a
h Notary Public 4�}}aato�rFlorida
Commission No. Michelle Trott;3eal1
o y Commission HH 101604
SUPERVISOR PLANS I VEGETATION I SEA TURTLE I MANGRO
REVIEW I REVIEW REVIEW REVIEW REVIEW