HomeMy WebLinkAboutscan.SLC.PERMIT.APP.WTR.HTR.POLO.CHRISTINE.12.19.2018.BFP.PSLALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1211912018 Permit Number:
Building Permit Application
Planning and Development5ervices
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
Address: 10105 Wild Quail Dr- Port St. Lucie, FL 34986
Legal Description: POD 6 PUD 1 AT THE RESERVE WILLOW PINES WEST AT PGA VILLAGE (PB 42-33) LOT 3,
Property Tax ID W: 3322-621-0012-000-2
Site Plan Name:
Project Name: WaterHeater Tank Replacement
Setbacks Front Back: Right Side. Left Side:
DETAILED DESCRIPTION OF WORK:
Install AO Smith 50 Gallon Electric Water Heater Tank in Garage.
iiviiucu uiiu �Pcium—u
Gas Tank [:]Gas Piping
LJElectric LJ Plumb
Total Sq. Ft of Construction: _
Cost of Construction: $ 1200.00
yrs L (Generator
5Ft. of First Floor:
Utilities: Sewer Oseptic
Lot No. 3
Block No.
Windows/Doors
E] Roof = Roof pitch
Building Height:
OWNER/LESSEE: -...
'' OTlTRA`CTOR:
Name Christine Polo a Frederick Lincoln Heady
Name: Robert W. Ludlum
Address: 9554 Avenel Ln
Company: Benjamin Franklin Plumbing
City,_ Port St. Lucie State:FL
Zip Code: 34986 Fax: fila
Phone No. 7725-871-9494
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: Na
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: pennits@benfr inklinplumbeccom
State or County License: CFC1426801
IT value orconstrucrmn is>esuu or mare, a nccuirucu Nonce of commencement IS regomrea.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Appli cable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
COUNTYOF
Address:
The for sing instrument as acknowledged efore me
this[ day of
City:
Zip: Phone
State:
City:
Zip: Phone:
State:_
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address: teal sw s,,. Macem ema
Type of Identification
Address:
Produced
City:
ISignatureof Notary/ r' o ,
City:
O MMSM GGe
Zip: Phone:
.SION
Commission No. 2021
).
Zip: Phone:
FRONT
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 antl 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 agreethat 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 po n the jobsite
before the first inspection. If yyee4G77ntend to obtain financing, consult with le9�err r3 ey before
commencing: wopkor recor�(oz4C ur Notice of Commencement. — 75 _ X
Rev. 8/2/17
e of Ow essee/Contractor as Agent for Owner
SjbwtTreo Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTYOF
The fo ing instru nt was acknowI dged bftore me
this 7daddy o��f1 Q(. 2GL by
The for sing instrument as acknowledged efore me
this[ day of
,
/2i�ja/by
beof—hj LadItcrt—
Name ofperso making statement
V
Name of per making statement
Personally Known OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(signature. NotaryP I'?/ e9 HERNANDIM
ISignatureof Notary/ r' o ,
F. O
O MMSM GGe
Commission No.
„ IRES JeInOuNerMY 2B, 2021
.SION
Commission No. 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