HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO1MU TBE COMPLETED FOR APPLICATION TO BE ACCEPTED `l
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Building Permit Application p( �✓� h F
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 F I OR Ta Select 1110111 di upbe uxio%n,
,PROPOSED:IMPROVEMENT:LOCATION " - .
Address: 6759 Picante Circle, Fort Pierce, Florida 34951
Legal Description: Spanish lakes fairways Blk 53 Lot 8 (or 1387-1420)
Property Tax ID#: 1306-500-0238-000-4 Lot No. 8
Site Plan Name: Block No. 53
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION-OF WORK
Install a new shower valve and pan in the Master Bathroom.
CONSTRUCTION;(N FORMATION:
Additional work to e e orme un er t is permit—check a appy:
a0HVAC Gas Tank ❑Gas Piping Shutters ❑Windows/Doors
Electric R1 Plumbing -OSprinklers F]Generator Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 450.00 Utilities. Sewer F]Septic Building Height:
.OWNER/LESSEE: -.CONTRACTOR: -
Name Richard &Linda Graham Name: Greg R Bassett
Address:6759 Picante Circle Company: Wellworth Plumbing LLC
City: Fort Pierce State:Fl Address: 1016 Antilles Ave
Zip Code: 34951 Fax: City: Fort Pierce State:Fl
Phone No.772-801-8582 Zip Code: 34982 Fax:
E-Mail: Phone No. 772-579-2462
Fill in fee simple Title Holder on next page(if different E-Mail: wellworthplumbingllc@aol.com
from the Owner listed above) State or County License: CFC1428815
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW]NFORMATION
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: x 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
commencing work or recording our Notice of Commencement.
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_Signature of wner/Lessee/Agent Signature rcontractor/License Holder
STATE OF FLORIDA!\`—b_�Lk-e_'
STATE OF FLORIDALCOUNTY OF �S COUNTY OF Ltc, 4�
Tho in instrl nt wQsaccnowled ed efore me The for instr wa ackn wledge efore me
thiay of V L� 20�y this y of 20�by
(Name of person nowled ing) (Name of person owledging)
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(Signature of Nota P I , F rida) (Signature of _ ic-Sta lorida)
Personally Known We�eAU it�8pn Personally Knov6ff'LOO�;'��� obex`11 on
Type of Identificat" �c tate of F Type of Identificatiol_g, u r rare f"
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Commission No. B0°dedthrou9( � Al 27.2019 Commission No. Nario°arNo `��
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Revised 07/15/2014
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