HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 07/08/2021 12:46PM 7723367272 The Plumbing Works PAGE 01/02
All APPLICAB E INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Num /�ber• I 0-7' v 324 RECEIVED
Building Permit ApplicAtiO:r► JUL 0 8 2021
Planning and Development Services QL e CQ ty
Building and Code Regulation Division Commercial_ Resident
2300 Virginia Avenue,Fart Plerce FL 14982
Phone:(777)462-1553 Fax: (772)462-1578. _
PERMIT APPLICATION FOR:
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Address:_L`Z_ I 5 IF jP—Y-OL n It—LCa
Property Tax ID#: "J oo— � -' f of No,
Site Plan Name: Block No.
Project Name: c!! :� &
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s a U Inan r u 01.E rya
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New Electrical Meter Si?cond Electrical Meter (Affidavit requir
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Additional work to be performed sander this permit—check all that apply:
—Mechanical G Tank —Gas Piping Shutters _Windows/Doors _Pond
Electric •'_ Plumbing T Sprinklers —Generator Roof: Pitch
Total Sq, Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction'$ _ 2 Utilities: sewer _Septic building Height:
N ............ .....
Name Name:
Address: compahy: �aYV
City: state: Address:.......
Zip Code: Q Fax: City: c'f State:,
Phone No. i
_�_ Zip code: Fax:
E-Maii: k�� Phone No -;4 i 7� 7
Fti#In fe simple Titie Molder on next page(1f different F=Mai) S1I v1 ant_
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from the Owner listed above) State or County License _
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.
07/08/2021 12:46PM 7723367272 The Plumbing Works PAGE 02/02
IV)rNTAL lJAM
...: .. .... ..
DESIGNER/ENGINEER: _._.Not Applicable MORTGAGE COMPANY: Not Applicable
Name:— - Name:
Address:_ Address:
City State: City State:
Zip:_ Phone Zip: Phone;
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City City:
Zip:_ _ Phone: Zip: Phone:
OWNER/CONTRAaO•R 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
Sth€ch is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may re tAct or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions whic9 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 exeropt 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 to 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 record!qg your Notice of Commencement.
Connn.#
Signature of Owner/Lessee/ or as Agent for Owner ��c Exphr'KpV.12,2M3
STATE OF FLORIDA 1 atl A
COUNTY QF_ l� �
$wo (or affir n subscribed before me of Physical Presence or_Online ntotarization
this_day of 20� by
Name of person makings tement.
nown 7 Personally K0 roduced Identification
Type of lde tion I rodu
(Signatur of Notary Public-State
Jof Flo ' )
Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION $EATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE:
COMPLETED
v 5120/21