HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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 x
PERMIT TYPE: Plumbing Water Heater
PROPOSED IMPROVEMENT LOCATION:
Address: 3200 N Highway Al A 903
Property Tax ID#: 1425-600-0079-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Remove and replace Electric Water Heater with Rheem 38 gallon Electric Water Heater - Low
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ 900 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Glenn & Virainia Weiss TR Name:Adam Samnsc)n
Address:2518 NW 121 st Dr. Company:Southpaw Plumbina and Meterina
city: Coral SDrinas State:_ Address: 1458 SW Bartell Ave
Zip Code: 33065 Fax: city: Port St. Lucie State: FL
Phone No. Zip Code: 34953 Fax: 772-324-6531
E-Mail: Phone No 772-486-0914
Fill in fee simple Title Holder on next page(if different E-Mail Info@southDawwater.com _
from the Owner listed above) State or County License CFC1428285
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INJEkO TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE O COMMENCEMENT."
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ture of Our ee/Contractoras Agentfor Owner S" na ure of Cont— r ense Holder
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Name of person making
statement. Name of person making statement`
Personally Known ``bI OR Produced tdentifwtion Personally Known
Type of Identificat' Type of Identification •• vg : SARAJOHNSON
Produc <•"M! JOHNSON Produced -' . fY.COMMISSION#GG 32203G
• '_ MY OMM1$SION#GG 022030 % i._ EXPIRES:September 11,2020
)IRES.)September 11,2020 odd•,,o So lThtu Notary Public UMero'rilers
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(Signature of No u 1 tc- e oFlorida (Signature of Notary ubl' -S fe of Florida)
Commission No. l� \ I) lJ Commission
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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