HomeMy WebLinkAboutBuilding Permit Application • 02/18/2016 11 :04AM FAX 7726217882 ALL CITY PLUMBING Two IM0001/0003
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I Permit Number: `rcba��33�
RECEI'H FEB 182016
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRO.P.OSED:IMP O"VEMENT'LOCATION:
Address: 9210 Champions Way
Legal Description: Lakes at PGA Village Blk B Lot 16
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Property Tax ID#: 3334-501-0094-000-8 ; Lot Na.
Site Plan Name: I Block No.
Project Name:
Setbacks Front Back: i fight Side: Left Side:
DETAILED DES...IPT-ION OF.WORK.-':
Replace water heater with 50 Gal Electric,
CONSTRUCTION JI.NF0'RMATI 0N:
lona war to a orme urider t ispermit—the*cappy:
QHVAC Gas Tank ❑Gas Piping _Shutters I__l Windows/Doors
UElectric ❑✓1 Plumbing []Sprinklers Generator gRoof
Total Sq. Ft of Construction: I S .Ft.of First Floor:
Cost of Construction:$ 1000.00 Utilities:PSewer OSeptic Building Height:
OWNERAESS.EE.,F. : CONTRACTOR:
Name Alvin Deregla I Name: Jason E.Parish
Addres5:1703 Calderdale Court Company. All City Plumbing Two, Inc.
City: Hanover State:MD Address: PO Box 880641
Zip Code: 21076 Fax: City: Port St.Lucie State:FL I
Phone No. Zip Code: 34968 Fax. 772-621-7882
E-Mail: Phone No. 772`631-3038
Fill in fee simple Title Holder on next page(if different E-Mail: holly@allciiyplumbingtwopsl.com
from the Owner listed above) I State or County License: CFC1427492
If value of construction,is$2500 or more,a RECORDED Notice of commencement is required.
02/18/2018 11 :04AM FAX 7726217882 ALL CITY PLUMBING TWO fa0002/0003
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S.U. LEMENTALtONSTRUCTION LIEN LAW INFORMATION-
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DESIGNER ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: _ Name:
Address: Address: i
City: state: City: state: ;
Zip: Phone: Zip; Phone:
FEE SIMPLE TITLE HOLDER: x Nat Applicable BONDING COMPANY: x Not Applicable
Name: Name
Address' Address:
City: Ci :i
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Zip: Phone: ! zip: Phone: I
I certify that no work or installation has commenced ptior 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�ssociation 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 But Iding 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 Ciommencement must be recorded and posted on the jobsite i
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
ig ure of Owner/Lessee/Agent - I Signa re Contractor/L ense Holder
STATE OF FLORIDA, STATE OF FLORIDA '
COUNTY OF st.wac I COUNTY OF se wain I
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The forgoing instnir4nt was acknowledge before m The forgoing instrument was acknowledged before me
this ay of ZO �P_by this 'eth day of February ZO t n by
Jason E.Parish 1 Jason E.Parish .. i
(Name of person acknowledging} (Name of person acknowledging)
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J CA_ J &A-A.
(Sirdature.of Not4rY Public-State of Florida) I (Sign re of Notary P ic-state of Florida}
Personally Known x.. OR Produced Identification Personally Known x OR Produced Identification '
Type of Identification Produced Type of Identification Produced.
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Commission No �te438ae Seal ' I Ion No. FE843850 FQ
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BWRM
ANY 4QMENISION t1 '
r PAY r.1
ExlB�OCOObeir 18► 4$ E8 acmobet tee'
Revised 07/15/2014 i
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REVIEWS FRONT ZONING SUPERVISOR PLANS' VEGETATION 'SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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