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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 09/07/21 Permit Number: L�'� ©� ... 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 -WATER SERVICE PROPOSED IMPROVEMENT LOCATION: Address: 5904 CASSIA DR, FORT PIERCE, FL 34982 Property Tax ID # Site Plan Name: Project Name: _ 3402-610-0461-000-5 STEVENS WATER SERVICE )ETAILEU.DESCRIPTION OF WORK: , ' '`"���41 Qir, INSTALL NEW WATER SERVICE LINE FROM METER TO HOUSE Lot No._ Block No. OWNER/'LESSEE: CONTRACTOR: Name MICHELLE STEVENS Name: RONALD E MEEKS Address: 9904 CASSIA DR, Company: MEEKS PLUMBING INC City: FORT PIERCE State: FL Zip Code: 34982 Fax: Phone No. 772-559-6882 Address: 5555 US HIGHWAY 1, SUITE 1 City: VERO BEACH State: FL Zip Code: 32967 Fax: 772-569-7647 Phone No 772-569-2285 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail INFO(g�MF KSP UMBING, C OKA _ State or County License CFCO24535 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. DESIGNER/ENGINEER: __X_ Not Applicable MORTGAGE COMPANY: X Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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 STATE OF FLORI COUNTY OF C Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this JM day of September 12021 by , Name of person making statement. I Personally Known, OR Produced Identification Type of Identifioti0n Produced (Signature of Not y PGblic=-State of Florida ) Commission No. S � ; LORETTAM.THISAULT ( -MY COMMISSION # HH 116484 XV EXPIRES: August 10, 2025 ••• o's F, ? BMbOG TAN Notary PUWIC Uf1A2twtitW REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/20/21