HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/25/16 Permit Number: 1001 - 03-73
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 0
PRQPOSED l' PRO'EMENT LOCATION
Address: 9650 S. Ocean Dr.,Apt 605,Jensen Beach, FL 34957
Legal Description: Condominium parcel NO. 605, in The Princess, as recorded in O.R. Book 444, Page 998 and any
subsequent amendments therto, all the public records of Saint Lucie County, Florida
Property Tax ID#: 4502-610-0055-000-6 Lot No.
Site Plan Name: Block No.
Project Name: The Princess Condominium of Hutchinson Island
Setbacks Front Back: Right Side: Left Side:
DETAILED 7;7, 7777 77
DESCRIPTION OF WORK. .:4
Replace 38 gallon electric lowboy hot water heater with equivalent 38 gallon electric hot water
heater.
CONSTRUCTION INFORMATION
t—c ec appy:
Additionalworkto e performed under this perm!
a
0HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric Plumbing ❑Sprinklers 0 Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 750.00 Utilities:]Sewer Septic Building Height:
OWNER/LESSEE = .,y CONTRACTOR:
NameJames E. &Shelly M. Parker Name: Adam J.Van Etten
Address:9650S_ Ocean Dr.,Apt 605 Company: Master Plumbing
City: Jensen Beach State:FL Address: 2551 S.E. Clayton St.
Zip Code: 34957 Fax: City: Stuart State:FL
Phone No.772-800-3263 Zip Code: 34997 Fax: 772-287-0194
E-Mail:Jim.parker1218@sbcglobal.net Phone No. 772-287-2366
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: #27366
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
S P�L'ENCENTA LC EC �NATlOC
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 recor ed and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with I der r n attorney before
com mencim work or recordingNQur Notice of Commenceme4.
All ul Aj r S
_SignrOF
of Owner/Lessee/Agent Signature o Contractor/Lic nse older
STAT FLORIDA STATE OF FLORIDA
COUNTY OF Sir.y.s„c COUNTY OF �6Q 41' '-
The forgoing instrumen was acknowledged before me The forgoing instrument was acknowledged before me
this day of JWA 20 by this .2(day of Q& - 20 /t by
Ada 0,
(NaV/of person acknowleclng) (N ma a of person acknowledging)
(Signature of Notary Public-State of Florida) \ (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification v
Type of Identification Produced Type of Identification Produced fL�OL
�� '��a�•4�kS•a l.�S-O ���f
Commission No. (Seal) Commission No. FFA (Seal)
TERESA L BENNIG
Notary Pubic tate OT Brtda,
Revised 07/15/2014 o -My Comm.Expires Dec 2 2017,
Commission #.FF71 8''':=` `.
one a !=20111u; 1iAssn:
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