HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/15/2021 Permit Number:
�`L Ll-? (L'ML
Ririlirlino Parmit AnnfiCation
Planning and Development Services x
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION::
Address: 2209 S 34th Street Unit B
Property Tax ID #: 2417-702-0090-000/8 Lot No.
Site Plan Name:
Project Name:
Block No.
DETAILED DESCRIPTION OF WORK: I
Replace water supply from water heater to bathroom -with new connections at manifold. Abandon existing pipe
in place. New piping (3/4" PEX) located through attic with drops to manifold for connection.
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical
_ Electric
_Gas Tank
_X. Plumbing
Total Sq. Ft of Construction:
—Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Sprinklers _ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Cost of Construction: $ 1,415.70 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name EH Klueppelberq
Address. 7691 Wexford Way
Name: Adam Sampson
Company: Southpaw Plumbing & Metering Services, LLC
City: PSL State: FL
Zip Code: 34986 Fax:
Phone No. 772-834-6050 E-
Address: 1237 Delaware Ave.
City: Fort Pierce State: FL
Zip Code: 34950 Fax: 772-324-6531
Mail:
Phone No 772-486-0914
Fill in fee simple Title Holder on next page (if different
E-Mail info@southoawwa er com
from the Owner listed above)
State or County License CFC1428285
IIf value of construction is 2500 or more, a KtwKutu Notice or wrnrntnnF_CmCnL 13 1 CMUI. _U- I
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 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
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 Innrler r.r 204 n+tnrnnv hofnra rnmmPnrino wnrk or recnrding your Notice of Commencement.
Signature of Contractor - or - Owner Builder as applicable
STATE OF FLORID.� ii
COUNTY OF t�UG
affirme and subscribed before me of ✓ Physical Presence or Online Notarization
Swor*r�
this �of 20-11 by
Name of person making statem nt.
Personally Known OR Produced Identification
Type of Identi ' n Produced
(Sign ture of Notary Public- State of F ida)
Ryss Rebekah Hoy
o
No. NOTARY PUBLIC (Seal)
Commission
STATE OF FLORIDA
z = Comm# GG294610
Expires 2/17/2023
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 10/12/21