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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: January 15, 2018 Permit Number: 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 J PERMIT APPLICATION FOR: Plumbing III ENTLOCA Address: 2704 Placid Ave - Fort Pierce, FL 34982-5621 Legal Description: ----m w..�w.,.,.�,.......,na,..,�w.�m�..�u Property Tax ID #: 2421-606-0017-000-1 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 new AO Smith 50 Gallon Electric Water Heater in laundry room CTION INFORMATION: unm wuFn ry ue CONTRACTOR: ermrmea unaer mis permit —ete an m ❑Gas apply: ❑ City: Fort Pierce State:FL Zip Code: 34982 Fax: n/a Phone No. 309-678-5632 HVAC City: Port St. Lucie State: FL Zip Code: 34984 Fax: 772-871-9069 Phone No. 772-871-9494 Gas Tank Piping _II Shutters State or County License: FL #CFC1426801 / SLC #23584 Windows/Doors Electric ©Plumbing sprinklers hl Generator 11 Roof = Roof pitch Total Sq. Ft of Construction: 5 Ft. of First Floor: _ Cost of Construction:$ 1300.00 Utilities: Sewer 11 Septic Building Height: OWNER/LESSEE; .. ' CONTRACTOR: Name Mark A. and Melody LBRAND Name: Robert W LUDLUM Address: 2704 Placid Ave Company: Benjamin Franklin Plumbing City: Fort Pierce State:FL Zip Code: 34982 Fax: n/a Phone No. 309-678-5632 Address: 1631 SW South Macedo Blvd City: Port St. Lucie State: FL Zip Code: 34984 Fax: 772-871-9069 Phone No. 772-871-9494 E -Mail: pennits@benfranklinplumber.com Fill in fee simple Title Holder on next page I if different from the Owner listed above) E -Mail: permits@benfranklinplumber.com State or County License: FL #CFC1426801 / SLC #23584 11 .muc ui wnerrvam.n rs,IUVv or more, a rscwaocu nouce or unmmencement is regwrea. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable Name: Mad A. and Melody L. BRAND MORTGAGE COMPANY: Na me: Ruben w. LUDLUM Not Applicable Address: 27" Paad Ae-Fad Perm. FL xee2-6621 Address: 2704Putdd Ave FLORICOUNTYDA City: Fodnwae State: _ Zip: Phone City: roast L.U. Zip: Phone: State: _ FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Name: _Not Applicable Address: 1631 SW south Maoado BW 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 Counttyy 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 att mey before commencinitwork or recordine vour Notice of Commencement. igMure ontractor as Agent for Owner Sigmffure of Con e Roder STATEOFFLORIDA�/ /,,_ STATEO F 1 ,te, FLORICOUNTYDA Gf'Kil COUNTYOF The fgojng instrum nt was ackn wI dged before me this day of 20 by The fg%Qmg Instrum this day of ��� was acknowI dgaQbefore me . 20//b' by Name ofpers9P making statement Name of pensg� making statement Personally Known ✓ OR Produced Identification Personally Known V OR Produced Identification Type of Identification _ Type of Identification _ Produced Pruc d //e► ignatur of Notary Public- AS of Florida ) (Sigilature of l Public- State f Florida ) Commission No. 7 (Seal) Commission No (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Hev. aj2yv