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HomeMy WebLinkAboutBuilding Permit Application 772-770-0064 ARS 08:11:21 07-01-2015 1/4 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 156 Q fly 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: Plumbing }��{ yFw r r-'a'- -�'" .r'"{ �7. :Z.a e• i u y ci- j.:�4S..s � R �1 IOL ' IO' C`tt p�},• x5.'J �t'G 3`7 �-F^'F t R C Y'YS. J.tY�ry.Y L... 1 1 �fc l.Y.; t.1`... Y $Rt..}..rJ LSJ J C1.r t. .:.�r.w -. ..Lu.w E Ry. 1. Address: 2804 Kingsley Dr,Ft Pierce,FL 34946 Legal Description: Sheraton Plaza Unit Three Replat Lot 235 ............. ...............- --.... - - — - .....-- - -- --....- -- --._..........- - --- -- -............................... Property Tax ID#: 1432-806-0103-000-6 Lot No.235 Site Plan Name: Boston,Willie Block No. Project Name: Boston,Willie Setbacks Front Back: Right Side: Left Side: .....x.:xfc- :.,r;_•.�r'.a:.`1..' .:A4�,x :� o;arr.-ui.tee:i?r;�...q--•a-fysL�ryw. ,...a�S...�...�5'cxw. �.`lc:';+.w..T..Lr?• `'.�'v�dpye-'at`;..-r-�..?'^.M,TIc'R11�:,.'�✓roa,�'Fry'..a1moh-wcc,s"'�f�t` rxt'' '.^ ar 1 yay,`1! Now-.^..Y1a;c7'rflyt-..-c1i'ij l„t[`lrtC" p �p�I rm" Exact change out of water heater, 40 gallon natural gas in laundry roam. ;/yam `1.-�5."'''T�}(�' a�.` - t4...s'yr..Cci x.r„ -`. t., ,u3 x e f p .y. t i ir•, ; y _ ^.s x"M©_��i}f�4 � ��.'�� ��� 1�•``1"yff'til.,s f1 f �t �.SYF'�t�'. y ..'. L.w'd1n ..�,.:s} -2L.Yr3..::..r-_ T.3..��r F.'�, .. ...e»:K Additional work to be nerrormpa un er this permit-Check all appy: E1HVAC I_1 Gas Tank ❑Gas Piping _Shutters l]Windows/Doors Electric Plumbing ❑Sprinklers Generator Roof Total Sq. Ft of Construction: Sq.Ft.of First Floor: Cost of Construction:$ 1465.00 Utilities:[]Sewer[ISeptic Building Height: �rA� ` sM,,. 4. .r. 1 a �. _r', �*` s Yiu✓'L,g ;-.- F �"`r�' 4 is u Y i s^ � RA� 3• c. i t,r a • i 3 c, Name Boston,Willie Name: Zacek,Dennis Address:2804 Kingsley Dr Company: American Residential Services City: Ft Pierce State:FL Address: 2800 US Hwy 1 Zip Code: 34946 Fax: City: Vero Beach State:FL Phone No. Zip Code: 32960 Fax: 772 794-9783 E-Mail: Phone No. 772 794-7221 Fill in fee simple Title Holder on next page(if different E-Mail: bderby@ars.com from the Owner listed above) State or County License: CFC1428283 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 772-770-0064 ARS 08:13:22 07-01-2015 2/4 L syv.,,6pb -Foe' 1•rs,. {+ [}/�{ .e '.fie'' .L z-L' ax ,ggOM - " 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: 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 thepermit 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 appro_ved_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 our Notice of Commencement. j s ignature of Own ssee/Agent Si ature of ContracioF/icense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF sw,, COUNTY OF St Lucie The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this.-t—day of Juliff 20 Lc5-by this_J_day of U 20 by 1 Dennis Zacek Dennis Zacek (Name of person acknowledging (Name of person acknowle (Signature of Notary Public-Sta(Gof Florida) (Signat�oflic(Sof Florida) Personally Known x OR Produced Identification Personally Known x OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. FFzzosso � r,• (Se C mmission No. FF2zos30 tITH A DERBY DERBY ''{ •'= MY COMMISSION/FF2=00 •e MY COMMISSION Y'• ••• 0CIPIRES-AWN 15.2019 ••... EXPIRES April 13,2019 4Q11 JR9d1'SJ flcrWNan'Y9e•vra.Carr' �fZ>��'%�y.y1� Revised 07/15/2014 rk «. S ..� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS