HomeMy WebLinkAboutBuilding Permit Application 1
ALL APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Permit Number: l 0�J4 (�n_
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RECEWED
Building Permit Application
APR 0 5 2016
Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing tlir e�
PROPOSED.IMPROVEM,ENT LOCATION.° . u
Address: 9013 PUMPKIN RDG
Legal Description: MAIDSTONE(PB 43-11) LOT 163 (OR 2480-2412)
Property Tax ID#: 3322-505-0172-000-4 Lot No.
Site Plan Name: Alan L Keller Saundra E Keller Block No.
Project Name: Alan L Keller Saundra E Keller
Setbacks Front Back: Right Side: Left Side:
DETAILED.DESCRIPTI:O'N;OF WORK: 4
50GAL ELE WATER HEATER
CON,8TRUCTION�ANFORMATION:
itiona workto e e orme under this permit—check a appy:
HVAC 11 Gas Tank EJGas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 550.00 Utilities:In Sewer Septic Building Height:
OV1/NER/LESSEE:aNTRACTOR: _
Name Alan L Keller Saundra E Keller Name: ERIC NERENBERG
Address:9013 PUMPKIN RDG Company: SERVICE AMERICA
City: Port St Lucie State:FL. Address: 2755 NW 63RD COURT
Zip Code: 34986 Fax: City: FORT LAUDERDALE State:FL
Phone No.772-323-1122 Zip Code: 33309 Fax: 954-977-3591
E-Mail: Phone No. 954-979-1100 EXT5673
Fill in fee simple Title Holder on next page (if different E-Mail: EPERMITSGROUP@SERVICEAMERICA.COM
from the Owner listed above) State or County License: CFC056891
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. `
SUPPLEMENTAL-CONSTRUCTION LIEN LAW INF.ORMATION:.
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 ice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you i e d to obtain financing, consult with lender or an attorney before
commencing work or recording ur otice of Commencement.
_
Signature-of-
ignature of weer/'L ss /Agent Signature Co.ntr to/License Holdetl
��-----=-��--�
STATE OF FLORIDA STATE F FLORIDA
COUNTY OF SAINT LUCIE COUNTY OF SAINT LUCIE
The foing instrument was acknowledged before me The forgoing instrument as acknowledged before me
this day of L—I 20 �y this a--day of � ,20 �by
ERIC NERENBERG ERIC NERENBERG
(Name of person cknowledging) (Name of person ac lo .I ging)
JESSICA DOTSON / . JESSICADOTSON t
MY COMMISSION k FF 072984 '`'
s._•' .= MY COMMISSION q FF 072984
EXPIRES:November 25,2017 ;'
(Sign -N rYi�°'$ta�� (Signature o Not P •bliC�' taeklt�nidal)�,PnblcUn�erwriler. Irk
'°> J.:
Personally Kn n OR Produced Identification Pe sonaIII nown OR Produced Identification
Type f Ide Ification Produced Typ entification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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