HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1g119 Permit Number:
• RECEIVED
Building Permit Application JAN 0 9 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential yes
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Ivp III
PRnprtCF6iMPpinivFMPNT I OrATIC)N r:
Address: 314 Essex or Fort Pierce, FL
Legal Description: Sheraton Plaza Unit 2 Replat Lot 41 SGANNE M
Property Tax ID q: 1432-805-0041-000-0
Site Plan Name:
Project Name: Gas Line Installation
Setbacks Front Back:
Installs 26ft of 1" polyethylene flex gas line
Installation of pipe will be at 18" depth
11HVAC LJ Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 1,200.00
Right Side:
Piping
Sprinklers
Left Side:
LJ Shutters
Generator
Spl —F—t.I of First Floor: _
Utilities:"nSewer Septic
Block No.
Windows/Doors
Roof = Roof pitch
Building Height:
,r
OWNER/LESSEE;
CONTRACTOR
Name Bobbie Kleckley
Name: James Marsala
Address: 314 Essex or
Company: Peerless Plumbing & Drain
City: Ft Pierce State:FIL
Zip Code: 34946 Fax:
Phone No. -
Address: 651 NW Enterprise or Unit 106
City: Ft Pierce State: FL
Zip Code: 34946 Fax:
Phone No. 772-223-1356
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: fames@peerlessplumbing.net
State or County License: CFC 1428692 LI39483
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCT]ON-LIEN LAW IN. FORMATION. F,...= ...
1,' .,_`.. : a.•
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address: 651 NW Enterynse Dr Unit 106
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded 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 vour Notice of Commencement.
Sf"gn�a _ r.Er6�f=Owrier/-Lessee/C6rittiactor_ as:A'gent for Ov ngr
Sign Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
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COUNTY OF QR
COUNTY OF . L � "A GAQ _
The forgoing instrument was a�knowleciged before me
this dday of ���Jr�f/ 20 �7by
The forgoing instrument was acknowledge jbefore me
this day of 20-M by
sHwJES IVIAQSAZ()- i
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Name of person making statement
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Name of person making statement
y
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Idpiqtification
Produced
Produwi
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(SignatureF3ilqnd
(Signature of otary a of FIo�SOR01U
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Commission No. commisfiift�jf 263732
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-- My Gmm. Eaplres Oct 1, 2022
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Rev.8/2/17