HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: to Permit Number:
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Build�ing Permit Application DEC /2 2016
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
PROPOSED IMPROVEMENT LOCATION:
Address: 6804 FROST TERR
Legal Description: OLEANDER PINES BLK 1; LOT 15; (0.25AC)OR 1409-1063; 1589-1245; 3861-21; 3889-1164
Property Tax ID#: 3415-705-0016-000-2 Lot No. 15
Site Plan Name: Block No. 1
Project Name: THERESA OLSON
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
M/B: remove and replace 2 lav with new undersink trims, replace shower valve; add thermostatic
mixing valve to m/tub
G/B: remove and replace 1 lav with new undersink trim, convert tub to shower; move drain to center;
add vinvi shower pan
CONSTRUCTION INFORMATION:
Additional work toe ertormed under this permit—check all appy:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
11 Electric WIPlumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 2976.00 Utilities:cn Sewer Septic Building Height:
OWNER/LESSEE: i CONTRACTOR:
Name //��fe_% 1 M I� Name: Robert Ludlum
Addressp:t_A64 rOS4r 1 p r Company: Aqua Dimensions Plumbing Services, Inc.
City: e(A+ Sf LU Li-P State:rt' Address: 1651 SW Macedo Blvd
Zip Code: 0L Fax: City: Port St Lucie State.FI
Phone No. ��T1��• 0 Zip Code: 34984 Fax: 772-343-7418
E-Mail: Phone No. 772-344-8433
Fill in fee simple Title Holder on next page(if different E-Mail: adps@aquadimensions.com
from the Owner listed above) State or County License: CFC057526
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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 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
commenic4ing work w recording our Notice of Commencement.
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Signatu a ner/Le see/Contractor as Agent for Owner Zigdafure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S�- ( -� COUNTY OF stL- a
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
th.is? _day of J)2eem b-ey 20 �by this.1st day of December 20 )lo by
ftA, Robert Ludlum
(Name of person acknowledging) (Name of person acknowledging
(Signature of Notary blit-St to of Florida) (Signature of Notary Pub(c-Sta of Florida}
Personally Known OR-Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type-of Identification Produced t., ;. : '4>• - ,
Commission No. EraSz/� ea mission No. Eee54297 lA DA 2 AFFERTY
.4, HONDA LAFFER Y �
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Revised 07/15/2014
af` EXPIRES January 08,2017 '• o i�,.'� EXPIRES January 08,2017
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