HomeMy WebLinkAboutBuilding Permit ApplicationALL 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:
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Run new water line from house to meter.
Lot No.
Block No: 4
lditional work to be ertormed under this permit —check all apply:
HVAC 11 Gas Tank E]Gas Piping _ Shutters Q Windows/Doors
Electric ✓❑ Plumbing OSprinklers Generator El Roof
Total Sq. Ft of Construction: 5Ft. of First Floor:
Cost of Construction: $ 300.00 Utilities: Sewer Septic Building Height:
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Name James Smith JR Name: Wade Case
Address: 1309 Parkland BLVD Company: Lindquist Plumbing & Supply Co., Inc.
City.. Fort Pierce State: FL Address: 3185 Sneed Rd.
Zip Code: 34982 Fax: City: Fort Pierce State: FL
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.
I
Not Applicable
MORTGAGE COMPANY:
Name: Name:
Address: Address:
City: Stater City: State:
Zip: Phone: Zip: Phone:
Not Applicable
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Add rens: 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
commencing work or recording your Notice;of Commencement.
_ Signature of Owner/ Lessee/Agent
STATE OF'FLORIDA
COUNTY OF G [-/C'
The far ping instrument was acknowledged before me
thisday of T-(., (-Y , 20 46b
P� h-0*TVn-r-r-R
(Name of person acknowledging)
t
(Signature of Notary Public- State of Florida )
Signature of Contractor/License Holder
STATE OF FLORIDAGCf
COUNTY OF s+. Lucie
The forgoing instrume—ntt as acknowledged before me
thI J O day of XUJ,-� , 20d6 by
(Name of person acknowledging )
ISg aturOoNota_ry Public- State of Florida)
s
Personally Known r OR Produced Identification Personally Known 4"' OR Produced Identification
Type Identification Pro �u , :''., EL E TR_ ,4 Type of identification Produce � t�LILE TKOTTA
MY M ISSION # EIESS9768 Cammissio Nr�U � y i' '; MISSIQN Jk EE8597,
Commission No. j EX�December 20, 2016 XPTIES December 20; 201
14071,398.0153 Fla1439N*WyS*FVJWC0ir 5407)30$4153 FW6d4N9Wy$jVyp9,gW
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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