HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED II(ID
Date: 1/25/2016 Permit Number: J� �� O`3S
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 IMPNTROVEMELOCATION P
g ;5
Address: 125 SE SERENATA COURT
Legal Description: RIVER PARK- UNIT 5 BILK 46 LOT 22
Property Tax ID#: 3419-540-0126-000-3 Lot No.22
Site Plan Name: Block No. 46
Project Name: ANGELONE
Setbacks Front Back: Right Side: Left Side:
DETAILED;DESCR)PTIONO_ `WORK �a
REPLACEMNT OF 3/4" PVC WATER LINE FROM METER TO FRONT OF HOUSE AT MAIN
SHUT-OFF AND TO SECOND HOSE BIB AT BACK OF HOUSE
CONSTRUCTION INFORMATION: ,
A
AdditionalI
work toe nertormed un er t is permit—check a appy:
HVAC Gas Tank OGas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers 1:1 Generator El Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 2,100.00 Utilities:cnSewer Septic Building Height:
OWNER%LESSEE p; CONTRACTOR
Name MARIA ANGELONE Name: RICHARD BASSOFF
Address: 3330 SE RIVER VISTA DRIVE Company: ADMIRAL PLUMBING SERVICES, LLLC
City: PORT ST LUCIE State: FL Address: 2895 JUPITER PARK DRIVE#700
Zip Code: 34952 Fax: City: JUPITER State:FL
Phone No.772-801-9686 Zip Code: 33458 Fax: 561 744-7101
E-Mail: N/A Phone No. 561 746-1180
Fill in fee simple Title Holder on next page(if different E-Mail: CHRISTINE@THEADMIRALPLUMBER.COM
from the Owner listed above) State or County License: CFC 1426115
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION 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
co t ecor ing your Notice of Commence
s
gnature of Owner/Lessee/Agnature Contract r/Licens o r
STATE OF COUNTY OF FLORIDA n�j ,4A COUNTY OF STATE OF FLORIDA PYA
The forming instryfrent was acknowledged before me The forgoing instrument was acknowledged,lb�efore me
this day of c ;0�Ld�M 20 �by this 2V day of ��/�"��'1 ,20 �by
(Name f person acknowledging) (Name of person acknowledging)
($gnature of Notary Public- tate of Florida) (Signat a of Notary Public-State of Florida)
Personally KnownOR Produced I ally Known t//OR Produced Identification
Type of Identification Produced 9" f Identification Produced •�� S
,` �•= M COMMISSION#EE 5�1142 � IRV)y J•,' :• ( Y�OMMISSION#EE851 2
Commission No�{$51)7�i ' e PIRESNovemberl ission No. ��
RES November 13,
(40f 388-0153 PW0N (407)3* 153 FW1daN .00m
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS