HomeMy WebLinkAboutBuilding Permit Application FEB-15-2016 22:55 FROM:ACE PLUMBING 7725678494 TO:17724621578 P.1/3
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO Be ACCEPTED
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Date: ;a—JiA- "�nlca Permit Number:
RECEI\'7D FEB 16 2016
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462- 553 Fax:(772)462-157$ Commercial XXXX Residential
PERMIT APPLICATION FOR: Plumbing
PROP'.05b IMPROV>~MENT:LOCATION:
Address: 2790 N US HWY 1
Legal Description: SID OF RUSSELL ESTATE 28 34 40 TRACT LYG S OF ST LUCIE BLVD AND W OF SR5 IN LOT 1
SID OF RUSSELL ESTATE-LESS US 1 AS IN D5K 1-33-(OR 1590-2005)
Property Tax ID#: '1428-501-0022-000-5 Lot No.
Site Plan Name: Block No.
Project Name; SUNOCO
Setbacks Front Back; Right Side; Left Side;
DETAILED DESCRIPTIONO F WORK;
RELOCATE HAND SINK BACK TO ORIGINAL LOCATION AND HOOK UP. INSTALL OWNERS
POINT OF USE HOT WATER HEATER. PUT EXISTING DRAIN LINE IN THE GROUND AND TIE
INTO EXISTING SEWER LINE,
CONSTRUCTION 1NPORMAT'ION:
itiona work-to a orme under is perms check a appy:
( HVAC 1.Gas Tank ,permit
Piping r,Shutters F Windows/Doors
Electric 21 Plumbing ❑Sprinklers Generator Roof
Total Sq. Ft of Construction: 5 Ft.of First Floor:
Cost of Construction:$ 850.00 Utilities;O Sewer Septic Building Height;
OWNER/LESSEE: CONTRACTOR:
Name SUPER STOP PETROLEUM INC Name: DANIEL WASHBURN
Address:$221 W ATLANTIC BLVD Company: ACE PLUMBING, INC.
City; MARGATE State:FL Address: 665 4TH PLACE
Zip Code: 33063 Fax: City: VERO BEACH State;FL
Phone No.1.964-907-9945 Zip Code: 52962 Fax; 772.567.8494
E-Mail: Phone No. 772-562.3780
Fill in fee simple Title Holder on next page if different E-Mail: ACE.PLUMB I NG@COMCAST.NET
from the Owner listed above) State or County License: CF0032636
If value of construction Is$2500 or more,a RECORDED Notice of Commencement is required,
FEB-15-2016 22:56 FROM:ACE PLUMBING 7725678494 TO:17724621578 P.2/3
.U,P.PLEM ENT LIEN, LAW MFUMATIQN:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City. State: City: state:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: 'A Not Applicable. BONDING COMPANY: Y 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
commencina work or recording our Notice of Commencement.
A I tit 1 Y14 'd ow J. du
S
_ ignature of Owner/Lessee/Agent Sigriature of Contractor License Holder
STATE OF FLQRI A n STATE OF FL RI A
COUNTY OF I CX �lopC - ____-- COUNTY OF i fin Lcm
Theorgoing instrument was acknowledged before me The forgoing instru ent was acknowledged before me
this day of �+�'v� ��= 20 LILA.by this day of 20 +r,,.i,J by
i
(Name of person acknowledging) (Name of person acknowledging)
(Sig ature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida}
Personally Known OR Produced Identification Personally Known OR Produced identification
Type of Identification Produced Type of Identification Produced
Commission No. o; � a APRIL pp
+�""""'h
APRIL ARINI Notary Public•$t L120,
4 Net P 1 xN M Comm My comm,Espirn Jul: 0.2017. `47°i« �" Commission N F
Revised 07/1.5/2014 ,,,�, Commissfon OFF-03694
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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