HomeMy WebLinkAbout1010 BUCKEYE DRIVE, FORT PIERCE, FL 34982 PERMIT APPLICATION PACKAGEAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 06/1112021 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) 462-1578
Commercial Residential X
PERMIT APPLICATION FOR:COLD WATER LINE REPAIR
PROPOSED IMPROVEMENT LOCATION: GARAGE
Address: 1010 BUCKEYE DRIVE, FORT PIERCE, FL 34982
Property Tax ID #: 3404-501-0538-000-7
Site Plan Name: WHITE CITY FROM NE COR S 112 OF Ol1TLOT 7, BEING PT ON W RNV Li OFOLEANDER AV
Project Name: Sec/Town/Range: 04/36S/40E
Lot No._
Block No.
DETAILED DESCRIPTION OF WORK:
SINGLE COLD WATER LINE REPAIR - DIAGRAM ATTACHED
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 _ Windows/Doors Pond
Electric X Plumbing _Sprinklers
—Generator _ Roof Pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction: $?_uil% ,00 Utilities:
_ Sewer J Septic Building Height:
OWNER/LESSEE _ ; •y
CONTRACTOR:
NameJETCO, INC
Name: MATT BLACK
Address:2985 CONIFER DRIVE
Company:BENJAMIN FRANKLIN PLUMBING
City. FORT PIERCE State:
Address:6945 NW LTC PARKWAY
Zip Code: 34951 Fax: N/A
City; PORT SAINT LUCIE State: FL
Phone No.215-531-8169
Zip Code: 34986 Fax: 772-871-9069
E-Mail:Jtiemanl943@gmail.com; amh825@hotmail.com
Phone No772-871-9494
Fill in fee simple Title Holder on next page ( if different
E-Mail PERMITS@BENFRANKLINPLUMBER.COM
State or County License CFC1430437
from the Owner listed above)
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; J
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name:_
Address:
City:
Zip:
Phone
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name;
Address:
City:
Zip:
Phone:
Name:_
Address:
City: _
Zip: --
Phone:
BONDING COMPANY,
Name:_
Address:
City:_
Zip:
Phone:
state:
of Applicable
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
stlructure. Pleasecconsult wv with Hlome ownome ers Assoers c
iation son and review
bylaws ur deed for any restr ct o s whichrestrict
may apply.
such
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 attorne before commencing work or recording our Notice of Commencement. _ ___
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Signat of Owner lessee/Contractor as Agent for Owner Signa ure of Contractor/license Holder
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STATE OF FLORIDA rr STATE OF FLORIDA S
COUNTY OF O+ Lu-vc e COUNTY OF
Sww rn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this t I day of , 2021 by
Name of person making statement. V
Personally Known OR Produced Identification
Type of Identification
Produced n Z
(Sigribture
aJY'a JULIE JANE MCCAULEY
Notary Public • State of Frl
Commrsslo # HH 49824
My Comm. Expires Oct 1, 2024
ug tional Notary Assn.
REVIEWS FRQ
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Sw ran to (or affirmed) and subscribed before me of
✓ Physical Presence or Online Notarization
this 11 day of &W,, , 20zd by
Al a-H R ( u, 0 4)
Name of person making statement.
Personally Known `ZstOR Produced Identification
Type of identification
Produced
(Signat66 o niv a ..Pubric at��t ¢� 1
;` • '`a`f': Notary =�.oac - State of F
Commission O Cormission 1 HH 498�-Seal
'� _pares Oct 1, :....
Bonded throLih National Notary
SUPERVISOR PLANS I VEGETATION SEATURTLE
REVIEW REVIEW REVIEW REVIEW
MANGROVE
REVIEW
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