HomeMy WebLinkAboutBUILDING PERMTI APPLICATIONALL..APPLICABLE INFO'MUST:BE COMPLETED FOR•APPLICATION TQ BE 'ACCEPTED
[)ate d 1p S.CqNNEp Permit'Number:,
Luca
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
,PP, OSfDIIVIPROVEIVIENT LOCATION' '
Address: 6803 SHELEY TER
Legal Description: OLEANDER PINES
Property Tax ID #: 3415-705-0005-000-2
Site Plan Name:
Project Name: BENAVIDES
Setbacks Front Back:
Right Side: Left Side:
REPLACE WATER HEATER 40 GAL ELEC
Lot No. 4
Block No. 1
Additional worK to be ertormeci under this permit— check all apply:
11HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
11 Electric ❑✓_ Plumbing Sprinklers E] Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 795.00 Utilities: Sewer 0 Septic Building Height:
{CONTRACTORt`' 3
Name SILVANA BENAVIDES
Name: ANTHONY F AGRUSA
Address: 6803 SHELLEY TER
Company: NORTH COUNTY PLUMBING
City: PT. ST. LUCIE State: FL
Address: 9056 N MILITARY TRAIL
Zip Code: 34952 Fax:
City: PALM BEACH GARDENS State: FL
Phone No. 561-866-5868
Zip Code: 33410 Fax: 5616258717
E-Mail:
Phone No. 5616259414
Fill in fee simple Title Holder on next page ( if different
E-Mail: NORTHCOUNTYPLUMBING@HOTMAIL.COM
from the Owner listed above)
State or County License: CFCO26530
it value of construction is SZ500 or more, a RECORDED Notice of Commencement is required.
S'UPPLEi1/IENiAL CONS1'R'IJCTI',ONN L/a L' IEUU INFO.R
kill I ° ► :
DESIGNER/ENGINEER: _;Not Applicable .
NIORTGAGE:COMPANY: T 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:
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 ins ectlo u intend to obtain financing,consult with lende attorneybefore
commencingw c�.rk or c Ing your Notice of Commenceent. �
Signature of Owner/ Agent/ Lessee Signature of Contractor/License Holder
STATE OF FLORI A ?)Sach
STATE OF FLCOUNTYOF COUNTY OF YY1 EWCh
The fpprgoing instr dent w1a`s acknowledged before me The fof oing instru jent w acknowledged before me
this I% day of Y 20 14 by this May of 20� by
Nm-�\OfvA ha S0. ASl
(Name of perso know ging) (Name of person owle g )
(Signature of Notary Pub "c- tate of Florida) (Signature of Notary Publ(Q.,�tate of Florida )
Personally Kno OR Procl c ti�i R is `g Personally Known �� �,,QR Produu=A. dl�11I`I` PA
Type of Identifi tr p�e�lotary Public - to e o id Type of Identificat `�6 Yp yp La NotaryPublic - State of Florida
"o;: Commissi # E 74567 = : » • My Comm. Expires Apr 20, 2015
• . My o q I€
Commission No. "r op�•y d Through`t��t�tMl Notary Assn. Commission No. ="r' - "a:� Commiss(%6ITE 74567
'Q•°I +• Bonded Through National Notary Assn.
Revised 07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS