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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �( � o�0/J� Permit Number: JCSq ' 11 © '•. RECE11.117D SEP2 91015 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 LOCATION: Address: 4918 Buchanan Dr Fort Pierce FL 34982 Legal Description: Indian River Estates Unit 1 bik 2 Lots 13 and 14 (map34/02N) Or 1815-801:2317-1998 2979-1274 Property Tax ID#: 3402-602-0058-000-2Lot No. 13 Site Plan Name: iN061 ott len4 Block No. 2 Project Name: Setbacks Front .Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Install a Replacement bath tub- no tile or drywall - tie into existing supply and drain line. CONSTRUCTION INFORMATION: Additional work toa er orme under t is permit—check a appy: HVAC El Gas Tank Gas Piping _Shutters l]Windows/Doors 11 Electric ✓❑ Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: SFt.of First Floor: Cost of Construction:$ 1700.00 UtilitiesliSewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Nancy Coutant Name: Michael Coleman Address:4918 Buchanan Dr Company: Premier Baths Inc City: Fort Pierce State:FL Address: 2330 S Nova rd Zip Code: 34982 Fax: City: South Daytona State.FL Phone No.772-465-6246 Zip Code: 32119 Fax: 387-546-7643 E-Mail: Phone No. 386-761-1830 Fill in fee simple Title Holder on next page (if different E-Mail: smorrison@premiercarebathing.com from the Owner listed above) State or County License: CFC1426886 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 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 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 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 Si atu_W of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDlj\ STATE OF FLORIDA COUNTY OF l f? �l ��� COUNTY OF The for ing instrume t w s acknowledged before me The�f/ofr�oing instrupen was cknowledged before me this. d of 20 by this b day of J fel_ 20 )5' by 44/11C fil IcAaCL 0"/f M,�7"X� (Name f person acknowledging) (Name of p son acknowledging) (S nature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known X OR Produced Identification Personally Known_ OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No.r]��DIS�r 1- (Seal) Commissio L MORRIS ipt �•pV6�•= sISi�B.Li{E i�LOI�IYa7ON afiv C4 201592 ,,{ p9Y COMM #ISSION PF201592 Revised 07/15/20]49 s EXPIRES February 19.2019 1 7)39801 EXPIRES February 19.2019 j I 14098- 53 FbridaAio7ary$ervfcy.utrr I 1407 39&0753 MridaN- rvira.QEn REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS