HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONSUPPLEMENTAL 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 TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
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.
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 recorde n the public records of St.
Lucie County and p n the jobsite before the first inspection. If yo=nto' btain financing, consult
with lender or .rn before commencing work or recording yommencement.
Signature of Owner/
as Agent for Owner i Signature of Contractor/License Holder
STATE OF FLORID", f STATE OF FLORIDA
COUNTY OF COUNTY OF � -
Swor o
n(or affirmed) and subscribed before me of
Physical Presence r Online Notarization
this day of 202d. by
Nam of Wson making statement. C.C�
Personally Known OR
Type of Identification
Sw r o (or affirmed) and subscribed before me of
Ph sical Presence or Online Notarization
this day of 2020 by
N0e of Orson, making statement.
Personally Known OR
Type of Identification
(Signatuure of Notary P
liq,,,gae of Fli R E S N I L L t7
(nature of Notary"
es�f Notar'�l Public
Commission No.
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Commission No. (!?CGS
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December 22, 2022
December 22, 2022
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Residential X
Address: 9963 PERFECT DR 158
Property Tax ID #: 3327-703--011 d-000_5, Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
50 Gallons tall electric heater located in loundry room on hallway, second floor, left side of the
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 Y Plumbing Sprinklers _ Generator e Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: `
Cost of Construction: $ d'3e2� Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Raul Torres Rabago
Name: Jorge F Granadillo
Address:1111 SE Westchester DR
company: Grana Electric Air Conditioning "&
City: Port St Lucie State: ^
Zip Code: 34952 Fax:
Phone No.
Address: 3073 SW Ann Arbor Rd
City: Port St Lucie state: FL
Zip Code: 34953 Fax:
Phone No 772 342-9713
E-Mail: "
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail granadillo699yahoo.com
State or County License CFC1430553
It 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.