HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/13/16 Permit Number: �"� • 0 ��
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
PRC P�OS.ED If1�fPROVEMLNT L0,CATI N �
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M_ ., .. . .,: ..x,
Address: 7506 Penny Lane
Legal Description: Lakewood Park Unit 7-BLK 82 LOT5 (MAP13/02N)(OR 3865-99)
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Property Tax ID#: 1301-607-0309-000-6 Lot No.39E
Site Plan Name: Block No. 34S
Project Name:
Setbacks Front Back: Right Side: Left Side:
DErtAILED DESCRIPTION 01= WQRK` r
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/7Vasv A.q 7aVzJ.0 4 (/J,"4aq
C �ISTRUCTIdIV INFORMATIONS k`
HVAC Gas Tank Gas Piping Shu Ate Windows Do
"ono work to M
orme un er t is ermit—c ec a �a❑ P g ❑, / ors
❑Electric ❑✓ Plumbing ❑Sprinklers Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:-$ 300 Utilities:Sewer❑Septic Building Height:
OWNER{LESSEE NTRACTOR
Name Chevrone Leslie Name: James Marsala
Address:7506 Penny Ln Company: Peerless Plumbing &Drain Services
City: Ft Pierce State:FL Address: 651 NW Enterprise Dr Suite 106
Zip Code: 34951 �/ qq Fax: City: Port Saint Lucie State:FL
Phone No. 77� TSO-�7Y7 Zip Code: 34986 Fax: 772-344-6359
E-Mail: Phone No. 772-223-1356
Fill in fee simple Title Holder on next page(if different E-Mail: James@peerlessplumbing.net
from the Owner listed above) State or County License: CFC 1428692
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SU'PPlE11lIENTA!CONSTR[1CTION !IE(V lAVI% INFQRMATION �_
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:
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
commencing work or re r 'n bur Notice of Commencement.
s
Signature o caner/Lessee/Contractor as Agent for Owner Signature of C ►xtractor/License Holder
STATE OF FLORIDA STATE F FLORIDA ,
COUNTY OF lsik.1.>� COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this-�day of 20 by this lu day of by
(Name of pers�eGowledging) (Name of son acknowledging)
(Sig ure of Notary Public-State of Florida) (Signature of Notary Public- ate of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identifications
Type of Identification Produced Type of Identificat' • -u
,•<Pa`��a, LASHAHNA INGRAM
Commission No. „�..„ ( Commission No. �2°. „os Notary Pub[�Se4I,te of Florida.
2�s tee; LAsHA NA INGRAM '_'* My Comm.Expires Dec 20,2018
Notary Public-State of Florida =9r �:� Com
mission
N, rr
#Q? m.Expires Dec 20,2018 Bonded through National Notary Assn.
9s �°•% Commission#FF 177249
Revised 07/15/ 1 OF F40p
""�"" Bonded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS