HomeMy WebLinkAboutscan.SLC.PERMIT.APP.WTR.HTR.RPL.COX.DAVID.05.14.2018.BFP.PSLALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05/14/2018 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 V
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 6707 Woodsmere Way - Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK-UNIT 7- BLK 86 LOT14 (MAP 13/02N) (OR 566-841)
Property Tax ID #: 1301-607-0372-000-8 Lot No. 14
Site Plan Name: Block No. 86
Project Name: Water Heater Tank Change Out
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install AO Smith 50 gallon electric tank-style water heater in laundry room.
CONSTRUCTION INFORMATION:
Additional work toe er orme under this permit — check a appy:
OHVAC 11 Gas Tank []Gas Piping_ Shutters ❑ Windows/Doors
Electric W1 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 1500.00 Utilities:11 Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name David K. and Shelva K. Cox
Name: Robert W. Ludlum
Company: Benjamin Franklin Plumbing
Address: 6707 Woodsmere Way
City: Fort Pierce State: FL
Address: 1631 SW South Macedo Blvd
City: Port St. Lucie State: FL
Zip Code: 34951 Fax: n/a
Phone No. 772-359-2791
Zip Code: 34984 Fax: 772-871-9069
E-Mail: n/a
Phone No. 772-871-9494
Fill in fee simple Title Holder on next page ( if different
E-Mail: permits@benfranklinplumber.com
State or County License: CFC1426801/SLC23584
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION':
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
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 thepermit 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 attorney before
commencin recordin ou-e of Commencement.
ature of Own ctor as Agent for Owner
Sig ature of Cont ctor/Lice older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgping instrum t was acknowledged efore me
this day of 20ffby
this day of , 20/Lby
1 " 4, / GSL
Name of per sor} making statement
Name of pers making statement
Personally Known ✓ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
d ANDEZ
Y COMMISSION # GG066499
(Signature of No�MfIPIRMJ#mry
(ignature of Nota y'P" M, S ` bf o a
`" COMMISSt # GG066499'
Commission No. 26, 2021
Commission No.4e SjfgM26, 2021
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DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17