HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q !�
Date: 09/01/2021 Permit Number.
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: PLUMBING
PROPOSED IMPROVEMENT LOCATION:
Address: 8143 Carnoustie PL Port St Lucie, FL 34986
Property Tax ID#: 3327 503 0024 000 1 Lot No.99
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Supply&install 50 gals electric Water Heater
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 _�_Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Q Sq. Ft. of First Floor:
Cost of Construction: $ t`� / S• Utilities: —Sewer _Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name .Q-,CZ_ 9u LC_ v Name: N I it G,v -r I L i(r.J
Address: �f/ `j CJ��/VO (/G f L Company:QUA( I L/ ?CYX(611✓G 't
City: t?b T sr state: R_ Address: l U, &)e
Zip Code: 3f5? Fax: City: State: c--
Phone No. 63 zqI- `f71 y Zip Code: 3 rt f9z Fax:
E-Mail: NOC.CO ./ 3 S-( g . Phone No 772 Z�W '-7S 71
Fill in fee simple Title Holder on next page(if different E-Mail t N r U td P (� , f C U005I^'G
from the Owner listed above) State or County LicenseCTL / `f 3 O Z
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:
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 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 our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signa ure of Contractor license Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF �>A- L`S L►'-L
Sworn to(or affirmed)and subscribed before me of Swo o(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this day of 2020 by this I day of 2020 by
Name of person making statement. Name of person making statement. /
Personally Known OR Produced Identification Personally Known OR Produced Identification y
Type of Identification Type of Identificati
Produced Produced
(Signature of Notary Public-State of Florida) (Signature of Notary Publi State of Florida)
Commission No. (Seal) Commission No. (Seal)
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