HomeMy WebLinkAboutBUILDING PERMIT APPLICATION PACKAGEAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05/17/2021
Permit Number:
�._ 'j
L. L 0 ° Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2309 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
r— PERMIT APPLICATION FOR: RELOCATING WATER LINES AND DRAIN LINES FOR SHOWER
PROPOSED IMPROVEMENT LOCATION:
Ac&r?ss: 919 JACKSON WAY, FORT PIERCE, FL. 34949
Property Tax ID #: 1423-802-0027-000-9
Site Plan Name: COASTAL COVES -UNIT 1- LOT 25 (OR 3929-1558)
Project Name. RELOCATING WATERLINES AND DRAINLINES FOR SHOWER
j DETAILED DESCRIPTION OF WORK:
RELOCATING WATER LINES AND DRAIN LINE FOR SHOWER
NEw Electrical Meter NIA Second Electrical MeterNlA
CONSTRUCTION INFORMATION:
fid6tional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank — Gas Piping _ Shutters
__ Electric Plumbing _ Sprinklers
Total Sq. Ft of Construction: —
Cost of Construction: $ 3822.00
_ Generator
Sq. Ft. of First Floor:
Lot No.25
Block No.
Windows/Doors Pond
Roof Pitch
Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
same ED WORTH
dcress:919JACKSON WAY
Name: MATT BLACK
Company:BENJAMIN FRANKLIN PLUMBING
City; PORT ST. LUCIE, FL. State;
:'i:) Code: 34949 Fax; NIA
hone No.772-871-9494
E-Pk all: PERMITS@BENFRANKLINPLUMBER.COM
Fill in fee simple Title Holder on next page ( if different
f,om the Owner listed above)
_ —
Address:6945 NW LTC PARKWAY
—
City. PORT ST. LUCIE State: FL
Zip Code: 34986 Fax: 772-871-9069
phone N0772-871-9494
E-Mail PERMITS@BENFRANKLINPLUMBER.COM
State or County License CFC#1 430437
If val_ie 3f 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:
DESIGNER/ENGINEER: X Not Applicable
Name:_
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: —
State:
x Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State: _
Zip: Phone:
BONDING COMPANY: X Not Applicable
Name:_
Address:
City;_
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.
I n 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 your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of C ntractor/License Holder
STATE COUNTOY OFORIDASTATE OF FL
_3f LLl u �COUNTYOFORIDA
Se,
Sworn to (or affirmed) and subscribed before me of
Ph sical Presence or Online Notarization
this day of 202# by
Name of person making statement.
Personally Known OR Produced Identification s/
Type of Identification
Produced ")Lr
,tiiiY �o`•.. JUUE JANE MCCAULEV
Notary Public • State of F,oriof
CQm r _:.:.e 0 uu 49824 l
OF My Comm. Expires Oct t, 2024
Swg� to (or affirmed) and subscribed before me of
y Ph sical Presence or Online Notarization
this day of 2020 by
l(l�
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signatu ry PubU0E5M1t(WA}� a
Notary Pubiic • State of Florida
.Omm15 Commission k HH 49824$ I)
e► EW"s Oct T, 2p 4
$onded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
nC)7 ucov_o-�-: o `l er
Permit No,
t :ate of Florida County of St. Lucie
NOTICE OF COMMENCEMENT
Tax Folio No
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes,
the %flowing information is provided in this Notice of Commencement.
Legal Description of Property: (and street address if available):
J.r� 1�t'iI tc. A-_57 U.V1T j —i4 CC3fZ '
General description of improvement: ck 3 <' c:;v� Ii Yam:, � s e��2CiC
Owner infor ation or 4ssee information if the Lessee contracted for the improvement:
Name ,` 1rt
?. Jdress f + C`
i terest in property:
�..me and address of fee simple titleholder (if different from Owner listed above):
Contractor's Name:BENJAMIN FRANKLIN PLUMBING
Contractor Addre55:6945 NW LTC EAERKWAY, PSL FL 34986 Phone Number: 772-871-9494
Surety (if applicable, a copy of the payment bond is attached): Amount of bond: $ NIA
N ame and address: NIA Phone number NIA
Lender Name: NIA Phone Number: NIA
Lender's address: N A
5-r y
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section
7:.3.13(1) (a)7., Florida Statutes:
N ame: NIA Phone Number: NIA
Address: WA
i� addition to himself or herself, Owner designates N/A of N/A
Lienor's Notice as provided in Section 713.13(1) (b), Florida Statutes.
F are number of person or entity designated by owner: NIA
to receive a copy of the
E,piralon date of notice of commencement: (the expiration date may not be before the completion of construction and final payment to the
crntractor, but will be 1 year from the date of recording unless a different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDEREC
ItiIPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IN"OR 7VEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
IN5PECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR
R-CORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of
rry knrlpdge and lef.
CXL- }r-
t
(Signature Df Owner or Lessee, or Owner's or Lessee's Authorized Officer/Director/Partner/Manager
a �r
Y;Signatory's Title/Office)
S--ATE OF FLORIDA
;:OU %TY OF � � L U CA,...
- 5e foregoin� instrument was acknowledged before me by means of 0 physical presence or ❑ online notarization this —Li day of
20 7 i.bv LUZ,. -4-* who is personally known to me or has produced _ V 1~ as identification.
JULIE JANE MCCAULEY
WI,
Notary Public - State of Florida
Commission k HH 44624
•)OTAR L'Ay Comm. Expires Oct 1, 2024
Bonded through National Notary Assn. N RY PUBLIC, State of Florida