HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� • fTl _ Permit Number: 1 I
RECEIVED
Building Permit Application
Planning and Development Services OCT 17 2018
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982' ST, Lucie County, Permitting
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Plumbing +-
PROPOSED'IMPRO.V.EMENT LOCATION:
Address: 2404 River Hammock Lane, Fort Pierce, Florida 34981
Legal Description: RIVER HAMMOCK LOT 2(0.50 AC)(OR 3159-2184)
Property Tax ID#: 3404-702-0002-000-8 Lot No.2
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace existing 40 gallon electric water heater in the upstairs closet, with a new 40 gallon electric
water heater
CONSTRUCTION INFORMATION:
Additional wor toe e Orme under tispermit—checkaIn-apply:
HVAC E] GasTank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing FISprinklers 11 Generator E] Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 1,400 Utilities:,n Sewer D Septic Building Height:
OWNER/LESSEE,,; . CONTRACTOR:
Name L0 + Name: ` 2
Address: 2 ,x� —' Company:
City: r" 't— -;P�t� State: -r-1 Address: '270 T i6 ti b
Zip Code: 3 tI q Kl Fax: City: -�_ �) G2 State:-'&-(—
Phone
tate: '&-(—Phone No. 77Z- S q '51 Zip Code:_ q�� Fax:
E-Mail: Phone No. 77Z— 7%— ZLIK2—
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: C Z
If value of construction is$2500 or more,a RECORDED Notice of commencement is required.
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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 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 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.
g ature of 0 r
er/Lessee/Contractor as Agent for Owner Signature of Contra I
or/License Holder
STATE OF FLORIDA1 STATE OF FLORIDA
COUNTY OF o l �9 C��(F_ COUNTY OF
The for ing instru nt w�s acknowledge efore me The for oing instrufn w s acknowledge efore me
this day of 20 .1by this day of LJ 20J& by
1
Name of pe son making s atement / Name Of person baking statement
Personally Known OR Produced Identification V Personally Known OR Produced Identification
Type of IdentifiGabion Type of Identific�;� ^�
Produced ProducedAA
Rr
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of F ori a)
Commission No. KARE Ta IELSEN Commission No. (Seal)
P
=1 1�i sState of Florida-Notary Public
+_ Commission # GG 207484
P.
P M Cornmi-si i CE
June 12, 2022 a ofFlorida-Notar Public
REVIEWS F R PLANS Vn3pe�C�RTLZ z 7MA ROVE
COUNTER REVIEW REVIEW REVIEWy�/ Ex ireRE EW
DATE
029
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
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