HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U
Date: Permit Number:
RECEIVED AUG 04-
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 xxxxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
;:PRO.P.,OSEDIMPROVEMENT LOCATION
Address: 1566 NW SWEETBAY CIRCLE, PALM CITY FL.34990
Legal Description: HERITAGE RIDGE, PLAT 8
Property Tax ID#: 4426-803-0037-000-3 Lot No.
Site Plan Name: Block No.
Project Name: GUEST BATH SHOWER PAN AND SHOWER VALVE+ RE-TILING
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
REMOVE OLD TILE, REPLACE LEAKING SHOWER PAN, INSTALL NEW POSI TEMP SHOWER
VALVE, RE-TILE
CONSTRUCTION INFORMATION: '
Additional work toe e orme under this permit—check a appy:
OHVAC E]Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 PlumbingSprinklers Generator F] Roof
Total Scl. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 2,395.00 UtilitiesOSewe rElSeptic Building Height:
OWNER/LESSEE .
CONTRACTOR:-
Name
CONTRACTOR:Name,JOSEPH P DEISLER Name: CHRISTOPHER M SEQUEIRA
Address:1566 NW SWEETBAY CIRCLE Company: CHRIS PLUMBING&BACKFLOW, LLC
City: PALM CITY State:FL Address: 11686 SE 13TH STREET
Zip Code: 34990 Fax: City: STUART State:FL
Phone No.772-834-7959 Zip Code: 34996 Fax:
E-Mail: Phone No. 772-341-7473
Fill in fee simple Title Holder on next page(if different E-Mail: CSPLUMBER@BELLSOUTH.NET
from the Owner listed above) State or County License: CFC 045990
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
150 - bd � �
SUPPLEMENTAL CONSTRUCTI LIEN LAW INFORMATION r
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 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.
s
_Signature of 0 r/Lesse4LAgen_t > Signature of Con actor/Licens der
STATE OF FLORIDA STATE OF FLORIDA C,e
S
COUNTY OF �`'U C COUNTY OF
The forgoing instrument was acknowledged before me The fP�rgoing instrument was acknowledged before me
this day of G�C/S 20 L 5 by this ` '�1 day of Uy a; &+ 20 l y by
(Name of p rson c o ledging (Na a of er o cknowle ging)
4�
(Signature of Notary Public-State of Florida) (Signature of Notary Public State of Florida)
Personally Known OR Produced Identification / Personally Known OR Pro cel Identification
Type of Identification Produced-- ,z Type of Identification Produced
S�E.0 Lxr' pG
Commission No.`� 1� °Ib (Seal) ;sz� .�4�.;;a Commission No. 12�U (Seal)
F. s �.I5 2 � 1
Da 3m.3-'C 17,201C-
Revised
0feRevised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS