HomeMy WebLinkAboutScan00217ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6(2712016 Permit Number:
Building Permit Application
Planning and Development Services
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: To Select: from dropbox, click arrow at the end of line
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Address: 6389 Chaska St.
Legal Description:
P ro pe rty Tax I D #: 3409-703-0041-004-1
Site Plan Name:
Project Name:
Setbacks Front ....___ Back:
Right Side: Left Side:
Run new water line from house to meter.
Lot No.
Block No: 4
Additional work to be ertormed unser tnis permit — cneCk all apply:
0 HVAC 11 Gas Tank E]Gas Piping _ Shutters Q Windows/Doors
Electric ✓❑ Plumbing OSprinklers 11 Generator E]Roof
Total Sq. Ft of Construction: 5 Ft. of First Floor:
Cost of Construction: $ 300.00 Utilities: Sewer Septic Building Height:
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Name James Smith JR
Name: Wade Case
Company: Lindquist Plumbing & Supply Co., Inc.
Address: 1309 Parkland BLVD
City.. Fort Pierce
State: FL
Address: 3185 Sneed Rd.
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-464-0989
Zip Code: 34945 Fax: 772-461-1999
E -Mail:
Phone No. 772-461-1969
Fill in fee simple Title Holder on next page ( if different
E -Mail: LindquistPlumbing@ymail.com
from the Owner listed above)
State or County License: CFC1428458
If value of construction is $2500 or more, a RECDRUED Notice of Commencement is required.
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DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
REVIEW
Name:
REVIEW
Address:
DATE
Address:
City:
_
State:
City: Stater
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Add rens:
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
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_ Signature of Owner/ Lessee/Agent
STATE OF'FLORIDA
COUNTY OF G [-/C'
s
Signature of Contractor/License Holder
STATE OF FLORIDAGCf
COUNTY OF s+r Lucie
The far ping instrument was acknowledged before me The fojrgoing instrument as acknowledged before me
this day of 20 /by this) day of v�ti 20d6 by
(Name of person acknowledging) I (Name of person acknowledging )
t
(Signature of Notary Public- State of Florida j
Personally Known M,'
Type g#Identification P
Commission No.
1407)
Revised 07/15/2014
MY POISSION # EIESS9768
EX December 20, 2016
{Sig ature o Notary Public- State of Florida )
Personally Known G� OR Produced Identification
Type of Identification Pr�foduce
WeHELL
Commission NO. F5/ y ��
AMISSION # EE8697
FRONT
4jjt XPI ES December 20; 2011
SUPERVISOR
140713BO�1fS3 flDild�N $gY1Ce.cOm
VEGETATION
REVIEWS'
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS