HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/21/2018
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: 7303 Palomar St - Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK -UNIT 1- BLK 9 LOT 17 (MAP 13/14N) (OR 528-174: 1366-1452: 1743-782).
Property Tax ID #: 1301-601-0175-000-9
Site Plan Name:
Project Name: Water Heater Tank Replacement
Setbacks Front Back:
Right Side: Left Side:
Install AO Smith 50 gallon electric water heater tank in garage.
Lot No.
Block No.
Additional worK to oe ertormed unser this permit — cnecK all n apply:
HVAC Ei Gas Tank E]Gas Piping _ Shutters Q Windows/Doors
Electric 10 Plumbing Sprinklers Generator El Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 1400.00 UtilitiestSewer Septic Building Height:
Name Mary C. Thomas I Name: Robert W. Ludlum
Address: 7303 Palomar St
City: Fort Pierce State:
Zip Code: 34951 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)
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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
N a m e: Mary C. Thomas
Address: 7303 Palomar St
City: Fort Pierce
Zip: Phone
Fort Pierce, FL 34951
State
MORTGAGE COMPANY:
Name: Robert W. Ludlum
Address: 7303 Palomar St
CitV: Port St. Lucie
Zip: Phone:
Not Applicable
State:
FEE SIMPLE TITLE HOLDER: Not Applicable I BONDING COMPANY: Not Applicable
Name:
Name:_
Address: 1631 SW South 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 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 your Notice of Commencement. �1
nature of Owner/ Lessee/Contractor as Agent for Owner I (Sig?T—ature
nse
STATE OF FLORIDA- ��{ STATE OF FLORIDA
COUNTY OF fd 1�l L' L COUNTY OF �1�`0
The forgoing instrument w acknowledged before me
this day of l .201k by
Name of person aking statement
Personally Known OR Produced Identification
Type of Identification
Produced
L HERNANDEZ
(Signature of Nota
Commission No.
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
26, 2021
The fooing instrume t was ac owledged before me
this r day of " 2!0 l2 IF
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced _
UJVAS �
(Signature of Notary
Commission No.
LHERNANDEZ
POION # GG066499
3 January 26, 2021
(Seal)
SUPERVISOR PLANS VEGETATION I SEA TURTLE I MANGROVE
REVIEW I REVIEW REVIEW REVIEW REVIEW