HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ' �P' �(!7 Permit Number:
Building Permit Application MAR 16 2016
Planning and Development Services PERidi1TT1JgGSt. Lucie County, FL
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 IMPROVEMENT LOCATION:
Address: 13261 NW Harbour Ridge BLVD
Legal Description: 4425-604-0010-000/4
Harbour Ridge Plat#5 Dewbarry Village
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name: Clayton master bath
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION-"OF WORK:
Remove tub and valves at master bath and replace with shower liner ,new valve
CONSTRUCTION INFORMATION:.
Additional work to "e e Orme under this permit—check a appy:
HVAC EiGasTank E]Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers E Generator 1:1 Roof
Total Sq. Ft of Construction: 120 Sq. Ft.of First Floor:
Cost of Construction:$ 2200 Utilities:F-/]Sewer W]Septic Building Height: 8#
OWNER/LESSEE: CONTRACTOR:
Name Margaret Clayton Name: Christopher M Sequeira
Address: 13261 NW Harbour Ridge BLVD Company: Chris'Plumbing&Backflow LLC
City: Palm city State:FL Address: 1686 SE 13th St
Zip Code: 334990 Fax: City: Stuart State:FL
Phone No.901-483-8941 Zip Code: 34996 Fax:
E-Mail: Phone No. 772-341-7423
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: C fC Oy S qR a
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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S,U,PPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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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
cornrueyming work or recording our Notice of Commencement.
Irl'tevv,Z."-q V, A
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ignature o wner/Lessee/A Signature of ContraOr/License Holder
STATE OF FLORIDA -D'
,t Z vcl C STATE OF FLORIDA L I
COUNTY OF COUNTY OF
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Tday of 14tLC f•1 20 L4 by this '7 day of ,-/A P-e- ,20 by
(Name oWrattedgin ) (Name of pers . k o g)
(Signature of Notary Public-State of Florida) r/ (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identific tion - Personally Known OR Produced Identification
Type of Identification Produced 1?R-) �t ti I C E a Type of Identification Produced DIL l V t '
Commission Gall No. )7 a WALTER m ission Nov(- ly �'��
Lit% •� WALTER QdM�
MY COMMISSION 0 F 28171GC)MMISSIGN"00,35 171
EXPIRES December 17,2019
Revised 07/15/2014 (40'-11 Sao; FbndSN0WA*—.eom ;,• EXPIRES December 17,2019
1�07)36D 0153 w■■wW914N2
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS