HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05/23/2018 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
Address: 7011 Willow Pine WAY - Port St Lucie, FL 34986
Legal Description: POD 6 PUD 1 AT THE RESERVE WILLOW PINES WEST AT PGA VILLAGE (PB 42-33) LOT 35 (OR 3782-128).
Property Tax ID #: 3322-621-0044-000-5
Site Plan Name:
Project Name: Water Heater Tank Replacement
Setbacks Front Back:
Right Side: Left Side:
Install AO Smith 50 gallon electric tank -style water heater in garage.
Lot No. 35
Block No.
Additional work to be ertormed under this permit — check all h apply:
HVAC Ei Gas Tank []Gas Piping _ Shutters Q Windows/Doors
11 Electric W1 Plumbing Sprinklers Generator El Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1600.00 Utilities: Sewer Septic Building Height:
Name Susan J. Kennedy
Address: 7011 Willow Pine Way
City: Port St. Lucie State: FL
Zip Code: 34986 Fax: n/a
Phone No. 772-359-6934
E -Mail: n/a
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: RobertW. Ludlum
Company: Benjamin Franklin Plumbing
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: permits@benfranklinplumber.com
State or County License: CFC1426801/SLC23584
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable
Name: Susan J. Kennedy
Address: 7011 Willow Pine WAY -Port Sl Lucie, FL 34986
City: Port St. Lucie State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address: 1631 SW South Macedo Blvd
City:
Zip: Phone:
MORTGAGE COMPANY:
Name: Robert W. Ludlum
Address: 7011 Willow Pine Way
City: Port St. Lucie
Zip: Phone:_
Not Applicable
State:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
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 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 fore
commencine work or recordine vo[fr Notice of Commencement. ---� i
ontractor as Agent for Owner I Sfg—nature of Contrau <I-icense Holder
STATE OF FLORIDA `. i STATE OF FLORIDA//- R
COUNTY OF , �� IrL ' COUNTY OF Si*U�- ce- e -
The for oing instrum t was acknowledge, efore me
this day of 20 /(,Y
go fazl-"
Name of persorymaking statement
Personally Known L OR Produced Identification
Type of Identification
Produced
of Not�r'Ii7j�Sdt�'FTo'PitiaG"�""""�---
:.. Y
C MISSI # GG066499
Commission No. 4%ES 4y 26, 2021
REVIEWS FRONT ZONING
COUNTER I REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
The forgoing instru nt was acknowledged before me
this -:13 day of _'20 ' y
Name of person„making statement
Personally Known 1 OR Produced Identification
Type of Identification
gnature of N
Commission No.
-"99* # GG066499
JluuW6, 2021
SUPERVISOR PLANS VEGETATION SEA TURTLE I MANGROVE
REVIEW I REVIEW REVIEW REVIEW REVIEW