HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 06/07/2018
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 d
PERMIT APPLICATION FOR: Plumbing
Address: 12192 RIVERBEND LN - PORT ST LUCIE, FL 34984
Legal Description: BAY ST LUCIE LOT 21 -LESS THAT PART MPDAF, FROM SW COR OF LOT 21, TH N 38 3223 E ALG SLY LI 63 FT TO POB: TH CONT N 38 32 23 E 67 FT TO WLY R/W LI CANAL C -32A,
TH N 51 27 37 W ALG WILY RM LI 15 FT, TH S 38 32 23 W67 FT, TH S 51 27 37 E 15 FT TO POB- (SUBJ TO ESMT TO C AND SFFCD) (0.65 AC) (MAP 44/22N) (OR 1319-2374:3105-336, 3457-2061, 2064).
Property Tax ID #: 4422-502-0024-000-3
Site Plan Name:
Project Name: Water Heater Tank Replacement
Setbacks Front Back: Right Side: Left Side:
Install Rheem 85 gallon non-metalic tank style electric water heater in garage.
Lot No. 21
Block No.
7aitional worK to oe
HVAC
nerTormea
Gas Tank
unser tnis permit — cnecK aii
E]Gas Piping
n apply:
_ Shutters
Q
Windows/Doors
Electric 171 Plumbing
Sprinklers
Generator
Roof
Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 3500.00
Name Fred K. Largey
Address: 12192 Riverbend Ln
S Ft. of First Floor: _
Utilities: SewerSeptic
City: Port St. Lucie State: FL
Zip Code: 34984 Fax- n/a
Phone No. 772-871-9494
E -Mail: n/a
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Building Height:
Name: Robert W. Ludlum
Companv: 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.
SUPPLEMENTAL, CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
N am e: Fred K. Largey
N a me: Robert W. Ludlum
Address: 12192 RIVERBEND LN - PORT ST LUCIE, FL 34984
Address: 12192 Riverbend Ln
City: Port St. Lucie State:
City: Port St. Lucie State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address: 1831 SwSouth Macedo Blvd
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 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 N ti of Commencement must be recorded and posted on the jobsite
before the first inspe . n. If yo in nd to obtain financing, consult with I or an attorney before
commend or r cordi r Notice of Commencement.
Sig u e of Owner/ ee/Contractor as Agent for Owner
Signa ure of Contra or/L• e H er
STATE OF FLORIDA-
WA �
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The for oing instru nt was acknowledge�j efore me
this � day of 0 7� by
The for ing instr t was acknowledge before me
this day 20 by
�1 ilk
we W141411
Name of pe rs n making statement
Personally Known V OR Produced Identification
Name of persgn making statement
Personally Known 1 OR Produced Identification
Type of Identification
Type of Identification
Pr Lice d
Produ d
( ignature of Notary 5U04 R X te�fAF�ERNANDEZ
(Signature of Notar Pw�i"; a
MDEZ
AUJO
Commission No. COM"pN # G(3066499
., ��• �,. EXPIRES January 26, 2021
Commission No. S *GGCE8499
,„ XPIRES January 26.2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17