HomeMy WebLinkAboutBuilding Permit Application ST LLICIE CO IMPACT PAGE 03/04
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04f2Z(2415 3:40PM FAX 7726217882ALL CITY PLUMBING T410
ALL APPLICAQLE INFO MUST BE COMPLETED FOR APPLICATION TO BE AC+COPTED
Date-• Permit Number: 1 Sa�1 a
w ; RECEIVED APN"2 31015
Building Permit APPtiCation
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenge,Fort Pierre FL 34982
Phone:(772)452-1553 Fax:(772)462-1578 Commercial Residential ,,,
PERMIT APPLICATION FOR: To Selact from dropbox, click arrow at the and of line
er
Pftdo'ostb;IM0KO'1lJrMENT CdCATIt3N
Address: 8321 Beif y Place -
Legal Description: POD 28 AT THE RI=SERVE LOT 69(OR 3330-1951,3361-1314)
Property Tax ib#: 3327-701-0072-000.0 Lot No.08
Site Plan Name- Block No..
Protect Name:
Setbacks Frortt. Sack: Right Side: left Sine:
fdQFVCREDStIfP '
; '
Install 40 Gal Electric Water Heater
.'G0NSTRUCriON°INFORM
l� '10'NA
_Mdltianal work to la a Orme• un er is perm --cn ec a app y:
❑HVAC Gas Tank FIGas Piping _Shutters Windows/Doors
CElectric i.y_l plumbing []Sprinklers 12 Generator Roof
Total Sq.Ft of Construction: _ — _ $a,R.of First Floor.
Cost of Construction:$ 850.40 Utilities:11 L.=!Septic Building Height.-
CONT
eight:CONT
Name Cynthia Gillen Name.. Jason E.Parish
Address:8321 Belfry Place Company- All City Plumbing Two,Inc.
City.. Port St.Lucie State:FL Address: PO%x 880641
Zip Code:.34986 Fax: City, Saint Lucie West State:FL
Phone No.801537.7203 "Zip Code. 34986_.. Fax: 772--621-7682
E-Mail: Phone No. 772-631.3038
Fill in fee sirnple'1'itle Holdar on next page J if differ" E-Mail: info@al1citypiumbin9Wyop8i.c0m
from the owner listed above) State or County License: OF01427492
if value of construction is$7500 or more,a R6CORDPD Notice of Commencement is required.
ST LUCIE CO IMPACT PAGE 04/04
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04/22/2015 0;41PM FAX 2728217882 ALL CITY PLUMBING TWO 1
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MIN ��c r u r`ivy"i.iE i i l�°it FOW;?�Ti
:{
RESIGNER/EWG-INEER; XNot Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address, Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE MOLDER: x 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
,� } ne Count makes no representation that is granting a permit will utharize the permit holderto build the subject structure
uucttu e, can se onsult Withpyour Home Owners eAssociaotionn and reviewyyc r deednfor any es icrich tmay alprohibit such
in considerattion 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:morn additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:YaLor failure to Record it Notice of Commencement may result in your paying twice for
improvements to yourproperty.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
commencingworm or recordln your Notice of Commencement.
r• 5
_Sig to of fpwner/lessee Agent sign re Cont, a se�Holder
STATE OF FLORIDA STA OF FLOR113A
COUNTY OF t_w-n COUNTY OF a u�w
The Gtlrki�8 instrtim t as. cknowledge�fare me The forgoing instrument was acknowledged hefore me
this 2y
of
z0. this a day of Air _ =20 by
(Name of person acknowiedgin,g) {Name of person acknowledging)
- A (�-W- A,1- &114kk
IS u re of Notary iic-State of Florida} (Signa re of Not tic-State of Florida)
Personally Known x OR Produced identification Personally Known x CTR Produced Identification
"type of identification Frodt I Type of Identification P ,
10 Commission No. 6680129 „- aw$ICA i”' mission No. +as$ r
MY Cowl.-ItIMN ft
EXPIRE$Oo%aber 1Fs, EX!?tf?ES art
?,mAsed 0711512014-
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGET'AT(ON SEA TUR7LZ MANGROVE.
COUNTER REVIEW REViM REVIEW REVIEW REVIEW REVIEW
RATE
COMPLETE
INITIALS