HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: August 3, 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 J
PERMIT APPLICATION FOR: Plumbing III
Address: 10208 S Indian River Or - Fon Pierce, FL 34982
Legal Description:
TH MEANDER RIV SLY 00.90 FT Mh, TH 3 09 DEG 55 MIN W753 13 FT wL, TH SOS DEG 55 MIN W753.13 FTMA_ TOE RAVFEC RR AND POB (1.30 AC) (OR 413-1737)
Property Tax ID #: 3529-234-0007-000-1
Site Plan Name:
Project Name: Water Heater Tank Chan
Setbacks Front Back:
Out
I DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Install a 50 gallon Rheem electric water heater tank in garage.
Lot No.1
Block No.
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name Mark Novak
Name: RoberlW Ludlum
war to
e e orme un ert
Is —checkpermit
a appy:
City: Pod St. Lucie State: FL
Zip Code: 34984 Fax: 772-871-9069
Phone No. 772-871-9494
_�Itmna
[JHVAC
Gas Tank
E]Gas PipingF-71Shutters
State or County License: CFC1426801
Windows/Doors
Electric
❑✓_Plumbing
Sprinklers
jj
t,J Generator
Roof Roof
pitch
Total Sq. Ft of Construction:
5
of First Floor:
Cost of Construction:
$ 2900.00
Utilities11
Sewer Septic
Building Height:
O W N E RAESSE E:..
CONTRACTOR:
Name Mark Novak
Name: RoberlW Ludlum
Address: 10208 S Indian River or
Company: Benjamin Franklin Plumbing
City: Fort Pierce State: FL
Zip Code: 34982 Fax: n/a
Phone No. 772-871-9494
Address: 1631 SW South Macedo Blvd
City: Pod St. Lucie State: FL
Zip Code: 34984 Fax: 772-871-9069
Phone No. 772-871-9494
E -Mail: nla
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
E -Mail: permits@benfranklinplumber.com
State or County License: CFC1426801
IT value or construction Is yZbuu or more, a KLUORUEO Notice of Commencement Is required.
UPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name: Mark Novak
MORTGAGE COMPANY:
Name: Pnoenw. LmWm
Not Applicable
Address: iozo6 a Indian Rivar Or Fon Piero, FL 36962
Address: 1020eamdiana1varor
STATE OF FLOR12V
City: Fon Pie. State:
Zip: Phone
City: Pon at. Wee
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address: teat awsevin Maeado Blvd
Address:
Name of person making statement
✓
City:
City:
Produced Identification
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 priorto the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an 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 anatto�rlBY before
commencine work or recd dine vour Notice of Commencement. ��iill
r
ure of Owner/ Lessee ontractor as Agent for Owner
514.8r6re of Ci5intractor/Licerriawoffler
STATE OF FLORID/! r
/
STATE OF FLOR12V
_9
COUNTYOF dU<YA�f'I.IDir-
_ .
COUNTYOF d1�1
for
The Ding instrument was acknowledged b3epfore me
The forgoing instrument was acknowledged before me
this day, of �,
20; by
this day of 20.,I?6y
Name of person making statement
✓
Name of pe� making statement
Personally Known OR
Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
PV
Ct
a " ' MARIO L HERNANDEZ
'�--MARM-4HERNAN�
'-"" e+ee
11i of Notary Pu te-
ictol iSSIONk13-o"_ a
(Signature of Notary P� ,3 p IReAvanmry19,2021
y
Commission No.
lq
E%PI §tj Januery26,2021
/
Commission No., r ea
REVIEWS
FRONT
ZONINGI'
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17