HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/30/2018 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: To Select from dropbox, click arrow at the end of line III
Address: 9405 Briarcliff Tree - Port St. Lucie, FL 34986
Legal Description: BRIARCLIFF AT PGA VILLAGE - LOT 12
Property Tax ID fl: 3322-801-0017-000-9
Site Plan Name:
Project Name: Water Heater Replacement
Setbacks Front Back:
Right Side: Left Side:
Lot No. 12
Block No.
..
I DETAILED DESCRIPTION OF WORK: III
Install a 50 gallon AO Smith electrical water heater tank in garage.
CONSTRUCTION INFORMATION: III
IJHVAC LJ Gas Tank
Electric ❑✓_Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 800.00
11L Ll
Piping
OWindows/Doors
ers LJ Generator Roof Roof pitch
SFt. of First Floor:
Utilities:12 Sewer ElSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Kristen Fitter
Name: Robert W. Ludlum
Address: 9405 Briarcliff Trice
Company: Benjamin Franklin Plumbing
City: Port St. Lucie State: FL
Zip Code: 34986 Fax: n/a
Phone No. 772-361-9444
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: Fla
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: permits@benfranklinplumber.com
State or County License: CFC1426801 / SLC23584
--.--- - -... - ..vo. oom.e n. wmmencemem is rc,uneo.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: moan Frazer
MORTGAGE COMPANY:
Name: Roben W. wa—
_ Not Applicable
Address: sous anamerrce- Pon St. wee, FL3a9%
Address: i anomie Tree
� I, , ..FLORIDA
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City: Ponst.wae State:_
Zip: Phone
City: Ponst.wae
Zip: Phone:
State:_
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address: 1631 sw seam rua ab NO
Address:
Nam personAaking statement
City:
City:
Personally Known V OR Produced Identification
Zip: Phone:
Zip: Phone:
Type of Identification
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 Count(yy 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 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 attorney before
cornmencing wo rdin r otice of Commencement.
Rev. 8/2/17
Signatur Owner/ Les
/ ontractor as Agent for Owner
Signature of Contract r/Li nse Holder
STATE OF FLORIDA
COUNTY OF
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COUNTY OFC�Yf�f�fif'L
The for Ding instru ent wa acknowledged efore me
this dayof20 by
The for Ding instru t was cknowledge efore me
this Qday of 2/0'��yJby
.yl
,/� ////''
b "f —1 1 /GL�� m
Name of perso}
making statement
Nam personAaking statement
Personally Known J/
OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification -
Type of Identification
Pr uce
Produ
(sig ature of Nota'
:$ f� N 6fK�
(Sig t e of Nota t § 'yIJGWI 0 GG069499
Commission No.
REa+9@y^y 29,2021
Commission Na. peen l�'2aYt
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982
772-462-1553
FAX 772-462-1578
AUTHORIZATION FORM FOR CREDIT CARD PAYMENT
TO: St Lucie County
RE:
Permit # %U 8,°Cl�iu!)LC�'
Credit Card Users: 1.5% Surcharge added per transaction.
Payments must be received in this department by 4:00 PM for transaction to be
processed that day, if not it will be processed the following business day.
VISA _ MASTERCARD
Credit Card Number
Expiration Date 423 Zip Code 3�f9851
3 digit security code 38�
Amount $ J! •!%9 + 1.5% surcharge
Business Name: Law;k)
Authorized Signature:
Print Name: 1)7zX-1O
Phone: (=) 87/ - R
Fax: ( 772) 97/- 90 9
Comments:
SLCPDSD Revised 4/01/2010 EN