HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/15/21 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential xx
PERMIT APPLICATION FORM/H Replacement —
PROPOSED IMPROVEMENT LOCATION: —
Address: 9969 Perfect Dr # 164
Property Tax ID #: 3327-703-016-000..7
Site Plan Name:
Project Name: Golf Villas II Unit 164 (OR 3998 -181)
DETAILED DESCRIPTION OF WORK:
Basic install 50 clal w/h, 20 " pan, thermal expansion tank, new ball valve and rrisc pipng
nPrmit & fees
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 S Ft of Construction: Sq. Ft. of First Floor:
Lot No._
Block No.
Windows/Doors Pond
Roof Pitch
q-
Cost of Construction: $ 1,250.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR_
NameP. Wischnewsky _
Name: David Spalding
Address:1042_ Laidlaw Dr _
Company:the plumbing works inc
Address:3473 sw europe st
City: milton on L9T 6S1 Canada State:
City: port st lucie _ Stater
Zip Code: Fax: _
_
Phone No._ _
Zip Code: 34953 Fax:
Phone No 772-336-7272
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail tpwoffice@gmail.com
State or County License cfc1428419 / 11717
from the Owner listed above)
If value of construction is zsuu or more, a Kt%,UKIJGtJ IVUu%.c U, �••• •� • If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: , Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
Zip: Phone:
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
is in aws or and any aprohibit such
which maor
strfucture. Pleaseconsultwithpyofur Home Owners Association andreviewyour deed or restrictions which
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
Building Codes and St. Lucie County Amendments.
in accordance with the approved plans, the Florida
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
fences, walls, signs, screen rooms and accessory uses to another non-residential use
accessory structures, swimming pools,
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
Commencement must be recorded in the public records of St.
improvements to your property: A Notice of
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencirRwork or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
Lwe%e- COUNTY OF_ 5I,-.Lw6e
COUNTY OF S+
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
Notarization
X Physical Presence or Online Notarization __& Physical Presence or Online
this � day of Mo.V . 202t by this �do ay of M", 2026 by
A4 ;V"' Name of person
Name of person m king statement. making sta ement.
Personally Known X OR Produced Identification Personally Known /X .._ OR Produced Identification
Type of Identification Type of Identification
Produced
Produced
- BRENDA R. DEC
of Notary Public- State Fl ) BRENDA R. DEC (Sign ure of Notary Public- State o l.,
(Signature y QI��¢., �;' Notary Public •State
state Florida
Notary Public • �r Commission N GG 3 0
Commission No. GG 31a775 + - ) Commission k GG 3 077�„ Sj�n No. �G 3 i�7 7,� '' 0' ;, I)My Comm. Expires Ju 1,
Expires Jul 1, jn
�o My Comm, Bonded through National N a
donded through National No ary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW
COUNTER REVIEW REVIEW
RECEIVED
DATE
COMPLETED _
ev.