HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/21/2016 Permit Number: /V'
RECEIVE®
Building Permit Application APR 2 1 2016
Planning apd Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (712)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing
PROD IMP OV
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POS R EMENTLOCATt �� .
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Address: 247 NE MAINSAIL STREET PORT ST. LUCIE, FL 34983
Legal Descr ption: RIVER PARK UNIT 9-PART C BLK 79 LOT 11
Property Ta�C ID#: 3419-57C )-0067-000'-4 Lot No. 11
Site Plan Name. Block No. 79
Project Name: HERRICK
Setbacks Front Back:. Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
RE-ROUTE 2" LAUNDRY AND KITCHEN DRAINS FROM THE BACK OF THE HOUSE, AROUND
THE HOME, TEE INTO EXISTING 4" PVC MAIN IN FRONT OF YARD WITH MINI LIFT STATION.
CC±NSTRUCTIO,N INFORMATION
Add Mona or
ON
nertormed under this permit—check all that appy:
11HVAG Gas Tank E]Gas Piping 1:1_Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator 1:1 Roof
Total Sq. Ft f Construction: S Ft.of First Floor:
Cost of Construction:$ 5,250 Utilities:Sewer Septic Building Height:
011/NER/LESSEE °' . °CONTRA p QR:.
Name BECKY HERRICK Name: RICHARD BASSOFF
Address:247 NE MAINSAIL STREET Company: ADMIRAL PLUMBING SERVICES, LLC
City: PORTIST LUCIE State:FL Address: 2895 JUPITER PARK DR#700
Zip Code: 34983 Fax: City: JUPITER State:FL
Phone No.X72-678-2012 Zip Code: 33458 Fax: 561 744-7101Q
E-Mail: Phone No. 561 746-1180
Fill in fee simple Title Holder on next page(if different E-Mail: CHRISTINE@THEADMIRALPLUMBER.COM
from the Owner listed above) State or County License: CFC 1426115
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIENIAW JNF,OR�MATION,�,e,.
DESIGN ER%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: I Address:
City: City:
Zip: I Phone: Zip: Phone:
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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 thepermit 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
co encin work or recording our Notice of Commenceme
,(AV- s
gnature o Owner/Lessee/Agent Signature of Contractor/Licen er
STATE OF FLORIDA STATE OF FLORIDA,
COUNTY OF PALM BEACH COUNTY OF PALM B
The forgoing instru ent•was acknowledged before me The forgoing instru gent was acknowledged before me
thisAl v day of 01 20 1. by thisr day of 20 by
(�u fil
(Name of -erss acknowledging) (Name of person acknowledging)
(Sig ture of Notary Public- a of Florida) (Sign ure of Notary Public-State of Florida)
Penally Known 0 nally Knowny OR
Type of Identification Produc ia�e�', Ae of Identification Produce ?', LARK C® A
�� ''t '•c MY COMMISSION#EE8 1142 y' J! '•i ': MY COMMISSION#EE85 42
Commission NIM
o.figI 1 ( fission No.�� I = ( ES November 13, 6
�IRES November 13,264 �', ,�
t401)�348.0153 Roddallotary MIM. X407)398-0153 FbddaNM lee.00m
Revised 07%15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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