HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1 1.
ALL -APPLICABLE INF MU T BE COMPLETED FOR APPLICATION TO BE ACCEPTED L'
Date: _Lk SCANNED Permit Number:
BY
St. Lucie County
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 Residential x
PERMIT APPLICATION FOR: '
To Select from dropbox, click arrow at the end of line � LA.�� th
L-F-KUI'UStUJlVIPKUVlzlVIlzN I LULA I IUN2
Address: 1740 PONDBERRY LN
Legal Description: LAKE LUCIE ESTATES
Property Tax ID #: 3426-703-0163-000-5 Lot No.149
Site Plan Name: Block No.
Project Name: DAVILA
Setbacks Front Back: Right Side: Left Side:
DETAILED°D'ESCRIPTION OF WORK."-
,•-
REPLACE WATER HEATER 40 GAL
`CONSTRUCTION. INFORiVIATION's�
Additional work to e e orme under tispermit—checka appy:
❑HVAC ID Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
❑Electric ✓❑_Plumbing []Sprinklers ❑Generator ❑Roof
Total Sq. Ft of Construction: _
Cost of Construction: $ 795.00
S Ft. of First Floor: _
Utilities:ll Sewer ❑Septic
Building Height:
:OWNER/LESSEE: Y' `�
CONTRACTOR t. r
Name ROBERT DAVILA
Name: ANTHONY F AGRUSA
Address:1740 PONDBERRY LN
Company: NORTH COUNTY PLUMBING
City: PT ST LUCIE State: FL
Zip Code: 34952 Fax:
Phone No. 772485-0689
Address: 9056 N MILITARY TRAIL
City: PALM BEACH GARDENS State: FL
Zip Code: 33410 Fax: 5616258717
Phone No. 5616259414
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: NORTHCOUNTYPLUMBING@HOTMAIL.COM
State or County License: CFCO26530
If value of construction is $2500 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:
Address:
City:
Zip:
Name: _
Address:
City:
Zip: Phone:
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 voLLr Notice of Commencement. i
Lessee
STATE OF FLORIDA
CO U NTY OF PALM BEACH
STATE OF FLORIDA
COUNTY OF PALM BEACH
Holder
The f ,r��QQing instru ent was acknowledged before me The forgging instru ent was acknowledged before me
thiso�'�°dayof �G. 20 14 by this.dayof 20 14 by
&L± my (b- Aftdv�,Qa ruse ,
me of person acknowledging) Name of perso now ding )
(Signatu of Notary Publi to of Florida) (Signatu7e of Notary Publk/state of Florida )
Personally Kno n r_,,._ ryh ��4a 1$� tion Personally Known A
Type of Identi c °lucR��� Type of Identifica o� d
` ` •= My Comm. Expires Apr 20, 2015 • _ , �; • My Comm. Expires ppr 20, 2015
Commission :� °05 mission(5e@�74567 Commission No. "• ° Commissibrl HE 74567
%9,`,Lto° Bonded Through National Notary Assn. ' '%%P,;o°`• Bonded Through National Notary Assn.
Revised 07/15/2014
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