HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 07/27/2018 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: 9420 Briarcliff Trace - Port St. Lucie, FL 34986
Legal Description: BRIARCLIFF AT PGA VILLAGE REPLAT NO. 1 (PB 48-30) LOT 4 (OR 2977-2003).
Property Tax ID #: 3322-803-0004-000-1 Lot No. 4
Site Plan Name: Block No.
Project Name: Water Heater Tank Replacement
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install an AO Smith 50 gallon electric water heater tank in garage.
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name Patrice Demers
Name: Robert W. Ludlum
Additional work toe rformed mer
HVAC Gas Tank
this permit — check
F_JGas Piping
a appy:
11 Shutters
a Windows/Doors
11 Electric 10 Plumbing
Sprinklers
EnGenerator
1:1 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1500.00
Utilities:n
SFt. of First Floor:
Sewer ESeptic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Patrice Demers
Name: Robert W. Ludlum
Address: 9420 Briarcliff Trace
Company: Benjamin Franklin Plumbing
City: Port St. Lucie State: FL
Zip Code: 34986 Fax: n1a
Phone No. 772-871-9494
Address: 1631 SW South Macedo Blvd
City: Port St. Lucie State. FL
Zip Code: 34984 Fax: 772-871-9069
Phone No. 772-8971-9494
E -Mail: n/a
_
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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
N am e: Patrice Demers
MORTGAGE COMPANY: _ Not Applicable
N a me: Robert W. Ludlum
Address: 9420 Briarcliff Trace -Port St. Lucie, FL 34986
Address: 9420 Briarcliff Trace
City: Port St. Lucie State:
Zip: Phone
City: Port St. Lucie State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: 1631 SW South Macedo Blvd
BONDING COMPANY: Not Applicable
Name:
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 Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If y erfd to obtain financing, consult with lender r an attorn before
commenndDg work or record' -yourNotice of Commencement. ,.
Rev. 8/2/17
5i ature of Owner essee
ractor as Agent for Owner
ure of Contracto
ense older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
%G
COUNTY OF
The f r ing instrum nt was acknowledge�efore me
tl- da of 20 by
The fg going instrum 'I t w
this day o
acknowledged before me
20 l b
6�4_w
644f4—
Name of person
aking statement
Name of person making statement
Personally Known
OR Produced Identification
Personally Known Ll
OR Produced Identification
Type of Identification
Type of Identification
Produced
Pr ed
r
MARIO L HRNANDEZ
'
(Signature of Notary I
t �FI
CO � ION # GG066499
(Signature of Notary i?4pr`�Iej 160gm1A113$lON # GG066499
Commission No. `&'�
PIRES January 26, 2021
(Seal)
Commission No.
IREry 26, 2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17