HomeMy WebLinkAboutBuilding Permit Application Dec 2316 09:20a First Choice Plumbing 7728797860 p.1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTE
Date: 12/27/16 Permit Nu ber: /��� 0z/-1 3,
RECEIVE®
Building Permit Applicatic n
c
Planning and Development Services DEC 2'7 2016
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 al the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 5623 Oleander Ave Port St Lucie FI 34982
Legal Description:
Property Tax ID#: 3409-114-0001-000-1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
install 1" water line from city meter to house
CONSTRUCTION INFORMATION:
Additional wor to be e orme under tispermit—c ec a appy:
❑HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
❑Electric Plumbing ❑Sprinklers ❑Generator ❑Roof u Roof pitch
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 800.00 Utilities:l0 Sewer❑Se Wc Building Height:
OWN E R/LESSEE: CONTRACTOR:
Nam plane Turman Name: M Joe Duran
Address:5623 Oleander Ave Company: First Cho a Plumbing Solutions
City: Port St Lucie State:Fl Address: 1687 Sw S macedo Blvd
Zip Code: 34982 Fax: City: Port St Lucie State:Ft
Phone No.772-579-8415 Zip Code: 34984 Fax: 772-879-7860
E-Mail: Phone No. 772-879-1414
Fill in fee simple Title Holder on next page(if different E-Mail: Firstchoicepliimbingsolutions@gmall.com
from the owner listed above) State or County Lic nse.CFC1427369
if value of construction is$2500 or more,a RECORDED Notice of Commencement is req dred.
Dec 2316 09:21 a First Choice Plumbing 7728797860 p.2
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COM 'ANY: Not Applicable
Name: Name:
Address: Add ress:
City: State: City.: State:
Zip: Phone: Zip: F hone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMP NY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: P one:
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 pern it holder to build the subject structure
which is in conflict with any applicable Horne Owners Association rules,bylaws or and co nants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for ai y restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in z I respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County A endments.
The following building permit applications are exempt from undergoing a full concurrent review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory u s to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement ma j result in your paying twice for
improvements to your property.A Notice of Commencement must be recc rded and posted on the jobsite
before the first inspectigA. If you intend to obtain financing, consult with Ic nder or an attorney before
commencing work or,,r6cording your Notice of Commencement.
VThe
ature of Own ctor as Agent for Owner Signa re of Contra o Lice se Hold
TE OF FLORIDA STAT OF FLORIDLINTYOF Srt LAA. a �-2..r COU OF'forgoing in trument was acknowledged before me forgoing in me t was acknowledged before me
s day off ZO j�by I this day of 20 1 _by
(Name of person acknowledging) (Name of person ackni wledging)
(Signature of Notary:��OR
tate of Florida} (Signature of Notary State of Florida)
Personally Known Produced Identification Personally Known 16 OR Produced Identification
Type of Identification Produced Type of Identificationc� roduced
Commission No , R'S o (Seal) Commission No� '1 d 71NAARAM O
�•"!'�'�.,, TINA A RAMALHQ �=NOTARY PUBLIC-STATE F FLORID
3i %NOTARY PUBLIC-STATE OF FLORIDA 3�,� o?g 46
Revised 07/15/2014 ds COMM.OFFS57046 fiAYCOMM.EXPlRES -03-202!
'` MY COMM.EXPIRES 02.03-2020
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