HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U
Date: G \ �`I Permit Number:
• i- RECEIVED
Building Permit Application
Planning and Development Services JUN 19
Building and Code Regulation Division permitting
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County,
Phone: (772)462-1553 Fax: (772)462-1578 Commercial esidential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Q,;v,
PROPOSED IMPROVEMENT LOCATION: !i
Address: 7508 Winter Garden Pkwy, Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK-UNIT 5- BILK 43 LOT2 (MAP 13/11 N) (OR 4098-2569)
Property Tax ID#: 1301-605-0073-000-6 Lot No.
Site Plan Name: WATER HEATER REPLACEMENT Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REMOVE EXISTING 40 GALLON ELECTRIC WATER HEATER, INSTALL NEW 40 GALLON
ELECTRIC WATER HEATER. SAME LOCATION - LAUNDRY ROOM.
F'
CONSTRUCTION INFORMATION:
Additional work toe er orme under this permit—check a appy:
HVAC 11 Gas Tank E]Gas Piping Shutters Windows/Doors
Electric RI Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 600 Utilities: 0 Sewer Z Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name } L—C4---CICt— STA-LASS Name: Pr OA(Y) Sly tD EDN)
Address: IW7-CCG Company: 1'tW m j rt
City: Mf---C..2 I-T 1S\—PrT\Yp 179 State:%_ Address: A'k-'F—
Zip Code: 32q 5-2 Fax: "— City: ill_ State:E�
Phone No. Zip Code: Fax: ` —3Z4
E-Mail: Phone No. 9'9-'z-4eU-cC1' Ie-1
Fill in fee simple Title Holder on next page( if different E-Mail: U
from the Owner listed above) State or County License: 2q ZO
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 AFF IDVIT: 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
commencing work or recording our Notice of Commencement.
Sig ature of Own ssee/Co ractor as Agent for Owner Signa ure of ContractorYtie4rise Ho er
STATE OF FLlDC`� STATE OF FLO
COUNTY OF . COUNTY OF
The fc ing instr ment was acknowledge�1 before me The foFgging instr ment was acknowledgFcJ before me
this day of 20 by this day of 2a,-&_ by
Aawm siman
Name of pe rso maki g statement Name of perso making state ent
Personally Known V OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced_
(Signature of Nota Pu iG> of FIoridBP)RAJ0HNSON (Signature of Notary u 1c t i ,of Florid�S RAJOHNSON
'
ISS'
#GG 022030 1
ISSION#GG O'L2030
Commission No. E( eptember 11,2020 Commission No. •a �abbtember 11,2020
•.,,oaFt2•' ru Pubic Underwriters '%lFor r oerBorded Thry Notary Public Urdenrrders
' .....t
REVIEWS FRONT ZONING SUPERVISOR PLANSVEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17