HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/16/2017 Permit Number:
=r.
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 V
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 3258 Lakeshore DR - Hutchinson Island [Fort Pierce], FL 34949
Legal Description: LAKESHORE AT SANDS (OR 1640-1177) UNIT 17 (OR 2506-2273)
Property Tax ID p: 1425676-0017-000-7 Lot No.
Site Plan Name: Block No.
Project Name: [8013r] Water Heater Replacement
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace failed 80 gallon solar/electric water heater tank with a new AO Smith [80 gallon] Solar Water
Heater tank in garage. --anW011i�-1k
CONSTRUCTION INFORMATION:
Additiona wor toe e orme under t,permit—cam a appy:
❑HVAC Gas Tank ❑Gas Piping _IShutters Windows/Doors
I�
❑Electric ❑✓_Plumbing ❑Sprinklers 11 Generator 0 Roof Roof pitch
Total Sq. Ft of Construction: SqI FFtt.I of First Floor:
Cost of Const ruction:$ 2000.00 Utilities:11 sewer 1:1 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:. -'
Name Ernest lanelli
Name: Robert W. Ludlum
Address: 3258 Lakeshore Or
Company: Benjamin Franklin Plumbing
City: Hutchinson Island [Fort Pierce] State: FL
Address: 1631 SW South Macedo Blvd
City: Port St. Lucie State: FL
Zip Cade: 34949 Fax: n/a
Phone No. 772-468-7444
Zip Code: 34984 Fax: 772-871-9069
E-Mail: n/a
Phone No. 772-871-9494
Fill in fee simple Tide Holder on next page I if different
E-Mail: Permits@benfranklinplumber
State or County License: CFC1426801
from the Owner listed above)
If value of construction is $2500 or mare, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name: Err..n.n.0
MORTGAGE COMPANY:
Name: Rnaed W. Ludlum
Not Applicable
Address:3258 t Ian MDR- HoClmcn Island[Fod Neral, FL 0949
Address: 3259 u�bm OF
COUNTY OF -o,',-
o,', .The
City: State:
Zip: Phone
City: Poo eL Lud
Zip: Phone:
State:_
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address: 1531 swscrum Mn xBIW
Address:
Personally Known + OR Produced Identification
City:
City:
Type of Identification
Zip: Phone:
Zip: Phone:
.Viii••,•,.,
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 1 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 yo r paying twice for
improvements Jtoyour prop otice of Commencement must I r and ted on the jobsite
before the first 1 echo you int nd to obtain financing, consult lender rney before
comme pr or copiliagyou Notice of Commenceme Ai, a
Rev. 8/2/17
S Lure dT Ci Lessee/Contractor as Agent for Owner
Signa ure of Contractor/Licalfise Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF s.n,LW.
COUNTY OF -o,',-
o,', .The
Theforgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 1s day of 20 by
this 15 day of;20 by
, 1 ; �W, Tum
Ro rk GW
Name of person making statement
Name of person making statement
Personally Known + OR Produced Identification
Personally Known J OR Pro ced Identification
Type of Identification
Type of Identification
Produced
Producetl
.Viii••,•,.,
(Signatur f Not `. =$ ;G as
(Signature off} P li •istatcGFNl0stlwll N GG0BN9S
/' EXPIRES J nu 28.2021
Commission No. �Sea9�
EXPIRES J 2g, 202t
Commissio
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17