HomeMy WebLinkAboutBuilding Permit Application ?an 091702:27p First Choice Plumbing 7728797860 P,
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/0912017 i 10
Permit Nu ber:
Building Permit Applicati in RECOV
Planning and Development Services
Building and Code Regulation Division
JAN 0 9 2017
2300 Virgfnia 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,-t the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 5233 Deanna lane Ft Pierce Fl 34946
Legal Description:Green Acres
Property Tax ID#: 1430-702-001174-000-0 4z"010'a -00ly--ld-t9c) 0 Lot No.6
Site Plan Name: Block No. 6
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install 3/4" PVC water line from house t meter is 4- i
CONSTRUCTION INFORMATION:
Additional work tobe nertormed under this permit—check all=apply:
OHVAC 0 Gas Tank FIGas Piping "Shutters Windows/Doors
WI11 Electric Plumbing FISprinklers 0 Generator Roof Roof pitch
Total Sq. R of Construction: Sq. Ft.of First Floo':
Cost of Construction:$ 80D.00 Utilities:EiSewe r F-1 I epti c Building Height:
OWNERAESSEE: CONTRACTOR:
NameSusan Izes Name: NI Joe Durar
Address:5233 Deanna Ln Company: First C1 oice Plumbing Solutions
City: F1 Pierce State:Fl Address- 1687 Sw S Macedo Blvd
Zip Code: 34946 Fax: City:Port SI Lucie State;FI
Phone No.772-501-5765 Zip Code: 34984 Fax:772-879-7860
E-Mail: Phone No. 772-879-1414
Fill in fee simple Title Holder on next page(it different E-Mail: Firstchoiceplumbingsolutions@gmaii.com
from the Owner listed above) State or County License: CFC1427369
I III
lfvalue of construction is$2500 or more,a RECORDED Notice of Commencement is r?quired.
__ I
Jan 0917 02:27p First Choice Plumbing 7728797860 p.2
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE CON PANY: ,Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: hone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: hone:
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 per nit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and co enants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for ny restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in ill respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County A mendments.
The following building permit applications are exempt from undergoing a full concurrenreview:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessoryil
es to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement y result in your paying twice for
improvements to your property.A Notice of Commencement must be rerded and posted on the jobsite
before the first inspection. If you intend to obtain financing,consult withrideror an attorney before
commencing work or recording our Notice of Commencement.
"(� s
Si nature of Ow a Contractor as Agent for Owner aSATE
ature of Co ct r se Holder
ATE OF FLORIDA OF FLORIDOIINTYOf 1\S�� NTY OF �.v.
The fg1going instrument was acknowledged before me The forgoing instrumc it was acknowledged before me
j this day of.� 20\�J_by this 9—day of7s UiN 20 XJ_by
(Name of person acknowled i ): WNameof",rsonackrowledgin
(Signature of Notary Public- of Florida) {Signature of Notary Pubdl�icStafe ot Florida)
Personally Known OR Produced identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No_�: (Seal) Commission No. (Seal)
.�jO1u4,,, TINAARAMALHO
+puna :W °�e
Revised 07/15/2014 .*`ovB�, TINA A;AM =o Gn N07ARY aUBLIC STATE OF FLORID
gi g'SNOTARYPUBLIC-STATE OF FLORIDA 4 � COMM,#F:F957046
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