HomeMy WebLinkAboutBuilding Permit Application 03/09/2016 15:34 FAX 002/004
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/09/2016 Permit Number:
Building Permit Application MAR 0 9 2016
Planning and Development Services
Building and Code Regulation Division PER."AITTING
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential V
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: 3302 Avenue Q-Fort Pierce, FL 34947
Legal Description: SUNLAND GARDENS BLK 12 LOT 19-LESS S 10 FT-(0.18 AC) (OR 2783-1640)
Property Tax ID#: 2405-601-0243-000-9 Lot No.19
Site Plan Name: Block No. 12
Project Name:
Setbacks Front Back: Right Side: Left Side:
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AaClitional worK to be Dertormed uncler this permit—check a appy:
HVAC Gas Tank I]Gas Piping _Shutters ❑Windows/Doors
11 Electric Plumbing Sprinklers 1:1 Generator 01 Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 2300.00 Utilities: Sewer Septic Building Height:
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Name Name: Ben Franklin of the Treasure Coast LLC
Address: Company: dba Benjamin Franklin Plumbing
City: Stater Address: 1631 SW South Macedo Blvd
Zip Code: '2,t4q`4!1 Fax: City: Port St. Lucie State:FL
Phone No. �'"7l—�(o!-� g �(� Zip Code: 34984 Fax: 772-871-9069
E-Mail: Phone No. 772-871-9494
Fill in fee simple Title Holder on next page(if different E-Mail: Permits@benfranklinplumber.com
from the Owner listed above) State or County License: CFC1426801
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
03/09/2016 15:35 FAX IM 003/004
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DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: u�±e N�E.�r.{rNPoyt Ak±,„�trqpp�. lrti4H.Eca`1 11
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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 Count 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 inspecti ., f you intend to obtain financing, consult with lender or an attorney before
commenongtwork or "ing your Notice of Commencem nt. Alzy
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_Signature of Owner/Les a gentA, -*ofCont*rarcrofLe Holder
STATE OF FLORIDA / STATE OF FLORIDA
COUNTY OF COUNTY OF , : e—
.1
Thefor oIng instrumen N sack owledged before me The forgoing instrument was a9knowledged before me
this day of si 20 &by this_day of 6• 20 �by
(Name of person acknowledging) (Name of person acknowledging)
(Signat� Notary Pub' tate of Florida) (Signature of N Public-State o rida}
Personally Known OR Produced Identification Personally Known Oduced Identification
Type of Identificatii in Prnrhwari Type of Identification Produced
o`'w....aG, LESLI D ZELAYA "�°�"`. LES DI�ELAYA
Commission No. �` ::se �,r Commission No.
Y COMfvtl�s�N#FF165172
MYCOM I N.#FF165172
EXPIRES October 1,2018 ` + EXPIRES Q. ..% 1 2018
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