HomeMy WebLinkAboutBuilding Permit Application a
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: It��3d� 15 Permit Number:
T RECEIV'D OCT 0 1015
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
PERMIT APPLICATION FOR:
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PROP,<SD 1MAPROVE£MIEtNT„LOCATIONA ;t't,,
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Address: 1102.N 41st Street, Ft Pierce, FL 34947
Legal Description:PLAT 2 -SUNLAND GARDENS BILK 34 LOTS 1 AND 2 (0.36 AC) (OR 523-1958: 1260-1607: 1889-261
Property Tax ID#: 2405-703-0019-000-3 Lot No. 1 AND 2
Site Plan Name: Block No.
Project Name: Cypriana Smith - Connect to City Water
Setbacks Front Back: Right Side: Left Side:
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INSTALL NEW WATER SERVICE PIPING FROM NEW INSTALL WATER METER TO HOUSE.
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Additional work toa er orme un er t is permit—c N- a appy:
HVAC 11 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric Plumbing Sprinklers Generator El Roof.
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ ySo • cso Utilities: OSeptic Building Height:
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OW�f �ER��LESSEE x CONTRALTO
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Name Cypriana G Smith Name: Ronald E Meeks
Address: 1102 N 41st Street Company: Meeks Plumbing Inc.
City: Ft Pierce State: FL Address: 5555 US 1, Suite 1
Zip Code: 34947 Fax: City: Vero Beach State:FL
Phone No. 772-489-6320 Zip Code: 32967 Fax: 772-569-7647
E-Mail: Phone No. 772-569-2285
Fill in fee simple Title Holder on next page ( if different E-Mail: info@meeksplumbing.com
from the Owner listed above) State or County License: CFCO24535
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DE5IGNER�ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name; T
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
co nein work or recording our Notice of CommanAeZent.
—Signature ofOwner/ essee/Agent Signature of Contrac or/License Holder - — -- - -
STATE OF FLORID STATE OF FLORI
COUNTY OF ___l A COUNTY
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_2.L day of October 20 this 26 day of October 20 15 by
pt.NN�1 '
(Name of person ack ging) (NaArondging
{Signatu e o ota ub' -S ate of or (Sigc-S e o oridaPersonal) nown OR Produced Identification Pe� OR Produced Identification
ype o en i ica on Produced Type Identificatioff Produced
Commission No. (Seal) LORMAWTMfawlssion No. (Set RieT1'AM.YMJSAU�
NOTARYkJklt NOTARY PUBIX,_P-1,111k_1C 0P r-LOM DA- QTATc em El ORIDA
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Revised 47/15/2414 :Gang FF03031d" - ..Cam blit FFo393ia
E�Ihs 8110V2017-... E 8/10/2817
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW . REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS