HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA E FO 1ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I ,
Date: Permit Number ' I; I 'NO
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Building Permit Application',,." :"
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue Fort Pierce FL 34982
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Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _ E ,
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PERMIT APPLICATION FOR:
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Plumbing
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'PROPOSED IMPROVEMENT LOCATION: . , �; I , ii
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Address: 6102 ALEXANDRIA CIR
PALM GROVE S/D BLK K LOT 22 0.14 AC OR 1194-41'; 1940-886).
Legal Description: ( )(
Property Tax ID#: 3410-503-0322-000-5 Lotl o I I;)II
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Barbara A O'Beirne
Site Plan Name: � � Block No.
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Project Name: Barbara A O'Beirne
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: I" { i�,NII I' ¢
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40GAL ELE WATER HEATER CHANGE OUT
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�CONSTRUCTICIN INFORMATION:.
Additional wor to be nertormed un ert Ispermit—check all appy:
❑HVAC Gas TankGas Piping Shutters Windows Doors
aElectric 0 Plumbing Sprinklers Generator Roof: ': j l
Total Sq. Ft of Construction: Sq. Ft. of First Floor: 111i
Cost of Construction:$ 500.00 Utilities: Sewer❑Septic . Building Height:'
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"C►V1/NER/LESSEE: v CONTRACTOR': . :. � �, � � �
Name Barbara A O'Beirne Name: ERIC NERENBERG'
Address:6102 ALEXANDRIA CIR Company: SERVICEAMERI CAI!
Cit Fort Pierce State:FL Address: 2755 NW 63RD COURT_:
City: _ i
Zip Code: 34982 Fax: City: FORT LAUDERDALE. t I.:; I ;' Stt�at;e:F4'i
954-460-8546 33309 954-97713591
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Phone No. Zip Code: Fax.,' t
E-Mail: Phone No. 954-979-1100 EXT 5071;'-:` j :,1 I !( i
Fill in fee simple Title Holder on next page (if different E-Mail: EPERMITSGROUP@SERVI'CEAMERICA.COM
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from the Owner listed above) State or County License: CFC056891 �a
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
3 I fill:
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION., t"4`
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: N;ot dpplicable ' I f+
Name: Name:
Address: Address: �`. ' I {`
City: State: City: ;`;I I'
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Zip: Phone: Zip: Ph one":
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY r;I ,>, l'NotIQ{�pl6!A 61
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Name: Name: `��:i ill,l. .'I: In .liii`� '` ,: i 1
Address: Address:
City: City:
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Zip: Phone: Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
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St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the$.6 ct; t 5ucty,: I s``
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that>r"'ay restrict o 1 prohibit such
structure. Please consult with our Home Owners Association and review our deed for an restriction which ala
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In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects, pei form;th'e viorki j ''
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendrrlents..i
The following building permit applications are exempt from undergoing a full concurrency review room'addlb6fis !III
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to anothek[noh resi;den ial'luse'.I:?
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in �ourl a in 'Mice ort' !i.4i
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improvements to your property. A Notice of Commencement must be recorded,and'pbste o l e
before the first inspection. If you intend to obtain financing, consult with lender or an:a o neyefore �a I .i
commenci work or recordin our Notice of Commencement. I t ,
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Si nature -Coritr_a- / ecense Holder I' I
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STATE OF FLORIDA STATE OF FLORID
COUNTY OFSAINTLUCIE COUNTY OFSAINTLUCIE �; 1 (k I t'Fi i5 Ifi '�' II Illi ;j;_+I ,4` I•
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The for ing instrument acknowledged before me The forgoing instrument wasacknii,owled d i >je rxle`j i
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this day of 20 Cby this 29 day of s l f'1III`i
ERIC NERENBERG ERIC NERENBERG I,i is r i I I
(Name of person ac o I ging (Name of person ackno g)
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(S' nature of ota blit-St a a of Florida) (Signa re of No a blit-State of idir a
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ersonal Known OR Produced Identification Per onally K wn OR Prodt)ced.Ideritification I<I' Irl j
ype Identification Produced Ty a of Id tification Produced
Commission No. Commission
7� IcecICADO7S0 ea
y, - JESSICAOOTSON '�°' !''¢` MY COMMISSION k FF 0729841+,
MY COMMISSION U FF 072984 " .. ;'
EXPIRES:November 25,2017..
;oc N, �f Fl, Bonded Thru Notary,u c n envr ers. I l.y.; I
Revised 07/1 Bonded Thru Nolery Public Underwriters {
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SE4.TURTLE IV�ANGRO.VE
COUNTER REVIEW REVIEW REVIEW -REVIEW iREVIEW ! ;:IREVIE
DATE ; - I
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COMPLETE -- 41
INITIALS ':i 'i,• �; � :.: I� j; .l'LI ,i., '�I 1=�"i
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