HomeMy WebLinkAboutscan.SLC.PERMIT.APP.ELEC.WTR.HTR.TANK.RPL.LEACH.KENNETH.12.26.2017.BFP.PSL ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 2/2 612 01 7 Permit Number:
ME^
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 4
PERMIT APPLICATION FOR: Plumbing
r1Sff6POStT4MPROVEMtNTLOCATION:
Address: 3702 N Hwy AtA Apt 1201 - Fort Pierce, FL 34949
Legal Description: GRAND ISLE OF NORTH HUTCHINSON ISLAND CONDOMINIUM(OR 2231.1190)UNIT 1201 (OR 3809-2460).
Property Tax ID#: 1423-807-0042-000-5 Lot No.
Site Plan Name: Block No.
Project Name: Water Heater Tank Replacement
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install 50 Gallon Electric Water Heater Tank located within interior condominium utility closet.
CONSTRUCTION INFORMATION:
r�A0dn10n@1 wor to b a er armed un ert is permn—check all apply:
IlL�mIIHVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
ICI Electric ❑✓_Plumbing ❑Sprinklers ❑Generator ❑Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 2495.00 Utilities: Sewer❑Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Kenneth W. Leach Name: Robert W. Ludlum
Address:3702 N Hwy AtA Apt 1201 Company: Benjamin Franklin Plumbing
City: Fort Pierce State:FL Address: 1631 SW South Macedo Blvd
Zip Code: 34949 Fax:rya City: Port St. Lucie State:FL
Phone No.772-834-5902 Zip Code: 34984 Fax: 772-871-9069
E-Mail:nla Phone No. 772-871-9494
Fill in fee simple Title Holder on next page(if different E-Mail: Permits@benfranklinplumber.com
from the Owner listed above) State or County License: CFC1426801
If value of construction Is$2500 or more,a RECORDED Notice of Commencement Is required.
45UPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name:Kennoh w.Leach Name:POioen W.LudOm
Address:3702 N AV AIA Apt uol-Fon Piece.FL MK9 Address: 370114Hw AtAAp11301
City: Fon Pimm State:_ City: Pon sI.Luce State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address:teat sW sOOm Necado eiw Address:
City: City:
Zip: Phone: Zip: Phone:
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 ano 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.
Inconsideration 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 in d to obtain financing,consult with lender or an ttorney before
commencir k or record' ur otce of Commencement.
nature cf1),Vher/L&sxeefCcintractor as Agent for Owner Siglerure of Co / tense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF-O ,LOd. COUNTY OF aar,,wva
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ze day of of O w 20_ by this 26 day of 000n 20 by
R.Ixd W.Ludlum RoUan w Ludum
Name of person making statement Name of person making statement
Personally Known + OR Produced Identification_ Personally Known d OR Produced Identification
Type of Identifl cat n Type of Identification
Pr ced Produced
i
Signat reo Nota e r gnature *N.Ia
er8 nflal $i N/cco6wf6Commission No. cc 6s t, EKPIRESI9l0uY 26,1021 Commission NY XPIRES J�wld 26,2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLIIEMANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17