HomeMy WebLinkAboutBuilding Permit Application I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED //�,
Date: Permit Number : W®�' 0038 3
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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: Plumbing
PROPOSED IMPROVEMENT LOCATION: f
Address: 10044 S OCEAN DRIVE#206 JENSEN BEACH, FL 34957
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Legal Description: SEW WINDS CONDOMINIUM APT 206
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Property Tax ID#: 4502-804-0014-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Sides
DETAILED DESCRIPTION OF WORK
REPLACEMENT OF 30 GALLON ELECTRIC HEATER
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CONSTRUCTION INFORMATION .
Additional work toe e orme under this permit—check a appy:
❑HVAC Ei Gas Tank ❑Gas Piping _Shutters ai Windows/Doors
❑Electric 0✓ Plumbing ❑Sprinklers 1:1 Generator ❑ Roof
Total Sq. Ft of Construction: S . Ft. of First Floor'.
1.050.00
Cost of Construction:$ Utilities: _Sewer❑Septic Building Height:
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0.1NNER/LESSE,E: ' 'CONTRACTOR' c
Name CARLOS&NORELEY PAEZ Name: RICHARD BASSOFF
Address:111-35 PINE VALLEY DRIVE Company: ADMIRAL PLUMBING SERVICES, LLC
City: WELLINGTON State:FIL Address: 2895 JUPITER PARK DRIVE
Zip Code: 33414 Fax: City: JUPITER State:FL
Phone No.954-732-4751 Zip Code: 33458 I Fax: 561-744-7101
E-Mail: Phone No. 561 746-1180
Fill in fee simple Title Holder on next page(if different E-Mail:
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 LIEN LAW INFORMATION:
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:
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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 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 bender or an attorney before
commencing work or recording our Notice of Commencement.
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_Signature of Owner/Lesse Ag Signature f ontract r/License Ide
STATE OF FLORIDA PSTATE OF FLORIDA
COUNTY OF G��"n � COUNTY OF
The for ing instr ent was acknowledged efore me The forwing instr ment was acknowledged before me
thisabaday of l��' 20 �by this�`y day of l�S14 20 r(A by
(Name of pe sonacknowledging)
(Name of person acknowledging)
(Si
ture of Notary Public- ate of Florida) (Signa re of Notary, Public- tate of Florida)
allyKnown OR Produced Identification Pe onally Known 'i OR Produced Identification
Yype of Identification Produced Type of Identification]Produced
Commission No. [—�C• 95/1 Lf. eSAJSAN CLARK OffAi sion No. EE i"11� �'ye�''. 1 AN CLARK CO
MY COMMISSION#E 851142 '•; ;•i MY COMMISSION#EE851 42
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