HomeMy WebLinkAboutBUILDING PERMIT APPLIACTIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number:
BY
St. LUde Countv
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial xxx Residential
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
PROPOSED IMPROVEMENT LOCATION: . I
Address: 5300 SUN CITRUS BLVD.
Legal Description: 303440 BEGATSE COROF 200 FTOF N 245 FTOF NE 114 OF SW V4 RUN SOO 00 15WALGW RD RWL1 OF HAMMOND RD
Property Tax ID#: 1430-311-0006-000-1
Lot No.
Site Plan Name: Block No.
Project Name: D&D MOBILE WELDING
Setbacks Front Back: _ Right Side: Left Side:
I DETAILED DESCRIPTIONOFWORK: . I
INSTALL EMERGENCY EYE WASH STATION
CONSTRUCTION INFORMATION: I I
AQaitionaiworKtoDenertormed under this permit —check all apply: L
11HVAC Gas Tank E]Gas Piping Shutters Windows/Doors
11 Electric Plumbing []Sprinklers Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 857.57
S Ft of First Floor:
Utilities'll Sewer 11 Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name MASSA FAMILY HOLDING, LLC
Name: WELLWORTH PLUMBING, LLC
Address: 222 SW 21 ST TERRACE
Company: WELLWORTH PLUMBING, LLC
City: FORT LAUDERDALE State: FL
Zip Code: 33312 Fax: 954-791-8968
Phone No. 654-791-3385
Address- 1016 ANTILLES AVE.
City: FORT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No. 772-579-2462
E-Mail:- MARTINEV@DDWELDING.COM
Fill In fee simple Title Holder an next page (if clifferbrit
from the Owner listed above)
E-Mail: WELLWORTH PLUMBINGLLC@AOL.COM
State or County License: CFC 1428815
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: III
UtalUrNICK/ tiMU111MMIK: Not Appicarli MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: _ City: State:
Zip: Phone: Zip: _ Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: —
Not Applicable I BONDING COMPANY: —Not Applicable
Name:
Address:
City:_
Zip: —
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count makes no representation that is granting a permit will authorize the permit holderto build the subject structure
which is in conAct 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 your Notice of Commencement.
Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTYOF
The f. ing lnstru�neqt was ackrowleclge��efore me
this Sclay Of N" 20 A�L_by
(Name of person
-of Nota P lic- State of Florida
Known OR Produced Identification
Type of
Commission No.
17JIM016
Revised 07/15/2014
STATE OF FLORIDA
COUNTY OF
The forgoing ffnstruNen� was acknowledged before me
th is _& day of 20 15 by
(Name of pe��o acknowledging
(Signature of Notary Public- State of Florida )
I
Personally Known
Type of Identification
Commission No.
Maflin au hn
My COW EE 869398
Exp,,es 12JI812016
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