HomeMy WebLinkAboutHudock PL App(1)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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 CBDG Funding
PERMIT APPLICATION FOR: PLUMBING
PROPOSED IMPROVEMENT LOCATION:
4 ri rlrocc 5622 PLACE LAKE DR
Property Tax ID #: 1312-502-0054-000-5
Site Plan Name:
Drniort nlama' HUDOCK
Residential X
DETAILED DESCRIPTION OF WORK:
Remove existing bathtub and replace with walk-in jetted tub in same footprint.
With (2) GFCI circuits
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Lot No. 63
Block No.
,Additional work to be performed under this permit — check all that apply:
Mechanical Gas Tank _ Gas Piping _ Shutters — Windows/Doors _ Pond
X_ Electric &_Plumbing _Sprinklers _Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2400 Utilities: _ Sewer _ Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Angela Hudock
Name: _Joel Caslmlro _
Address: 5622 PLACE LAKE DR
Company: All State Plumbing Services
_
City: Fort Pierce _ State: FL
Zip Code: 34951 Fax: _
Phone No. 954-461-0729 E-
Address: 540 E Minnehaha Ave
city: Clermont State: FL
Zip Code: 34711 Fax:
Phone No 352-874-4225
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-mail rebecca(ay.permitgroupfl com
State or County License CFC057323
If value of construction is 2500 or more, a Rt(:UKutu Notice oT commencement is requireu.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phon
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Ap
State
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
Not 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
which conflicts with any. applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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
improvement to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie ounty nd posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with 10171cler o an attorney before commencing work or recording our Notice of Commencement
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Signature e / Lessee/ ontractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Martin
Sworn to (or affirmed) and subscribed before me of _ Physical Presence or X Online Notarization
this 02 day of November 2021 by
Name of person making statement.
Personally Known OR Produced Identification X
Type of Iden ^' a ion Produced FL DL
L�
(Signature of Notary Public- State of Florida)
Commission No. (Se Notary Public State of Florida
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<et,s,:ca E Stephens
My Commission GG 958848
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