HomeMy WebLinkAboutapplicationAll APPLICABLE. INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/420 Permit Number:
I
Building Permit Ap
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 Y
IOl- '1
RECEIVED
JAN 13 2019
Lucie County, Permitti
PERMIT TYPE: GAS PIPING
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID#: -
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
INSTALL GAS PIPING FOR NEW BUILDING AND
�e
— oLl/—oOG0— 600— �4, it Lot No.
V Block No.
I CONSTRUCTION INFORMATION: I I
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutte
_ Electric _ Plumbing _ Sprinklers _ Gener
Total Sq. Ft of Construction: Sq. Ft. of First Floi
Cost of Construction: $ 2500.00 Utilities: —Sewer _
I
I Windows/Doors
)r _Roof Pitch
ptic B I lding Height:
OWNER/LESSEE:
CONTRACTORiII;:
Name PB HOLDCO LLC
Name: CHRIS JOHNSON 1
Address: 3901 ST. LUCIE BLVD.
Company: CNJ PLUMBING LLC
City: FT. PIERCE State: _
Zip Code: 34946 Fax:
Phone No.772-465-6006
Address:1701 S. 37TH ST.
City: FT. PIERCE 0 State: FL
Zip Code: 34947 I Fax:
Phone No772-801-3073 1
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail CHRISJOANSON@FP I A.COM
State or County license 30950
1 1
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 9
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: I
Address:
Address:
1
City:
Zip: Phone
State:
City:
Zip:
i I State:
Phone: Y
� a
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
I V
City:
City:
I 1
Zip: Phone:
Zip:
Phone: I
I
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit!to do the work and installation as indicated.
1 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, inl all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County'Amendments.l
The following building permit applications are exempt from undergoing a full concurren'cy review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessoryuses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENT
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COM
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU Ire
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTII
IIT MAY RESULT IN YOUR PAYING
EMENT�MUST BE RECORDED AND
TO OBTAIN FINANCING, CONSULT
rnmwrwrcwctar n
I
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of ContraIctor/Licenseflolder
STATE OF FLORIDA
STATE OF FLORIDA
V
COUNTY OF �(I F .
COUNTY OF v�
I
y t 10&
The fo oing instru ent was acknowledged -before me
�
The for oing instru ent was acknowledg
1 jV
efore me
this day of 20Oby
this day of
20 by
-An.li1S 3n�'1SO0
Name of person makln atement.
Name of person ma' kin statemept.
✓
Personally Known ✓/ OR Produced Identification
Personally Known OR Produced
Identification
Type of Identification
Type of Identification
Produced
Produceda2z:
=
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(Signatu of Notary Public- State_ of Florida)
(Signat to r Public- State of Florida )
KAREN S. AUELSEN l."
Commission s+°;% IHa�w��MM
Florida- Public
"":'P' ,I KAREN S. NIELS&
Commi .�-.
-
• Commission N GG 207484 I,
_ Peal
e+fde-Notary ublic
=• •e Commission 0 GG 207484
IrBS
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June 12, 202
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a i121 2022
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DATE
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RECEIVED
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COMPLETED
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