HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I �+�
Date: Permit Number: 1��` o3s
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
PROPOSED.°IMPROVEMENT L'OGATION: "
Address: 7804 White Ibis LN
Legal Description: EAGLE'S RETREAT AT SAVANNA CLUB
Property Tax ID#: 3424-701-0046-000-7 Lot No.
Site Plan Name: Edwin A Stubbs Marcia A Stubbs Block No.
Project Name: Edwin A Stubbs Marcia A Stubbs
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION QF WORK: y.
30GAL ELE WATER HEATER CHANGE OUT
CONSTRUCTION'INFORMATION
Additional work toe e orme under this permit—check a appy:,
HVAC Ei Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric �✓ Plumbing Sprinklers El Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 400.00 Utilities: Sewer Septic Building Height:
OWNER/LESSEE: :CONTRACTOR: ' ,
Name Edwin A Stubbs Marcia A Stubbs Name: ERIC NERENBERG
Address:7804 White lbis,LN Company: SERVICE AMERICA
City: PORT SAINT LUCIE State:FL Address: 2755 NW 63RD COURT
Zip Code: 34952 Fax: City: FORT LAUDERDALE State:FL
Phone No.772-871-1764 Zip Code: 33309 Fax: 954-977-3591
E-Mail: Phone No. 954-979-1100 EXT 5673
Fill in fee simple Title Holder on next page(if different E-Mail: EPERMITSGROUP@SERVICEAMERICA.COM
from the.Owner listed above) State or County License: CFC05891
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Y
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION : '
DESIGNER/ENGINEER: ^Not Applicable MORTGAGE COMPANY: _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 pasted on the jobsite
before the first inspection. If y intend to obtain financing, consult with lender or Wttorney before
commencin work or recordi our Notice of Commencement.
_ _ s
_S gnature�of"Ow`n /..essee/Agent _ Signatur of Cont _ o License Holde J
STATE OF FLORID STATE OF FLO DA
COUNTY OF SAINTLUCE COUNTY OF SAINT LUCE
The oing instrument was acknowledged fore me The forgoing instrument was acknowledged before me
this day of �—, 20�by this 18 day of_7 20 `�by
ERIC NERENBERG ERIC NERENBERG
{Name of person ac o ledgi (Name of person a owiedg g)
r
{Signatur of Notary Pu is-State of Florida) {S' natur of Not Public-State of Florida)
Person lly nown o y t n �in Pers all Kno OR Produced identification
�f iq Y
Type entificati o Ct d COMMtSS1oN# 9.tt17 `� Ty ofldentifi ation Produced
:•: _
'* EXPIR .• �ndeiwr;tsrs
"=+;•....•o�• Bonded ihro Notary PuU'� �,�;;' ,,, —p—
Commission No. �,. e{ sa►: Commission No. o Y a a,;, JEJS WPTSON
MY COMMISSION#FF 472984
EXPIRES:November 25,2017
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS