HomeMy WebLinkAboutscan.SLC.PERMIT.APP.ELEC.30.GAL.WTR.HTR.TANK.RPL.CHAMPAGNE.PATRICIA.03.12.2018.BFP.PSLALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/12/2018 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 4
PERMIT APPLICATION FOR: Plumbing III
Address: 3017 Five Iron Dr - Port St. Lucie, FL 34952
Legal Description: LINKS AT SAVANNA CLUB (PB 40-39) BLK 36 LOT 5 (OR 1648-185).
Property Tax ID p: 3426707-0088-000-4 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 AO Smith 30 gallon electric water heater tank in master bedroom closet
CONSTRUCTION
IL
L�II(HVAC L._1 Gas Tank
Ll Electric 21 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 500.00
Piping
Its L,J Generator
5Ft. of First Floor: _
Utilities:Sewer Septic
OWindows/Doors
0 Roof = Rapti
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Patricia J. Champagne
Name: Robert W. Ludlum
Address: 3017 Five Iran Dr
Company: Benjamin Franklin Plumbing
City: Port St. Lucie State: _
Zip Code: 34952 Fax: We
Phone No, 772-879-7120
Address: 1631 SW South Mai Blvd
City: Port St. Lucie State: FL
Zip Code: 34984 Fax: 772-871-9069
Phone No -772 871-9494
E -Mail: We
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: permitsiQbenfranklinplumber.com
State or County License: CFC1426801
n value or construction is az: uu or more, a XtCUNUtU notice of commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name: Pael la J. champagne
MORTGAGE COMPANY:
Na me: aoeen W. Luawm
Not Applicable
Address: W17 Five Iron or- Pon St. Lude, FL 39653
Address: 3017hn,1anor
OF
City: Ponst Lude State: _
Zip: Phone
City: Pon at. wee
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address: +sa, sw somh roma- eiw
Address:
Name of person aking statement
Personally Known / OR Produced Identification _
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 bulId the subject structure
which is in conFlIct with any applicable Home Owners Association rules, bylaws or antl 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 ypu''Rtgnd to obtain financing, consult with lender or an attorney before
commencing wnck.nr recordit36 60Motice of Commencement. � 11 /7
Rev. 8/2/17
Signature of 0 ner/ essee/Contractor as Agent for Owner
Sign re of Contra /License Holder
STATE OF FLORIDA
COUNTY Y�(�,�
FLORIDA
L�CiI`C/
OF
!'LSJ
The f
this 1li5ay of /r 20�by
The fgr$�ing instrume w s ac owledged before me
this LL—day of 20by
/V-�GudiAA�_
Name of person aking statement
Personally Known V OR Produced Identification
Name of person aking statement
Personally Known / OR Produced Identification _
Type of Identification
Type of Identification
ProdarzaaL
Produced
(Signature of Nota [Pu C-1twe mf7 II61a6N k GG066499
(Signature Of Nptar: �.�,
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`I . F EX E9 Ja 26, 2021
I HpGOOaNa9
'R'YL .
EXPI 26.2021
Commission No. (Seal
Commission N.—Ow
tlM
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17