HomeMy WebLinkAboutBuildling Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ,2/� 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 X
PERMITTYPE: Water Heater Residential
PROPOSED IMPROVEMENT LOCATION:
Address: 3101 Kingsley Dr. Ft. Pierce, FL 34946
Property Tax ID #: 1432-807-0029-000-6
Site Plan Name: SHERATON PLAZA -UNIT FOUR REPLAT LOT 271 (OR 4130-600)
Project Name: Allon Yarkony
DETAILED DESCRIPTION OF WORK:
40 Gallon electric water heater change out, residential
Lot No. 271
Block No.
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit— check all that apply:
_Mechanical
_ Electric
_ Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ $250.00
Gas Piping
_ Sprinklers
_ Shutters
Generator
Sq. Ft. of First Floor: _
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Allon Yarkony
Name: Brent Martin
Address: 5230 SW 38th AVE
Company:One Call Florida, Inc.
City: Ft. Lauderdale State: _
Zip Code: 33312 Fax: 772-409-8620
Phone No. 772-223-8400
Address: 7804 SW Ellipse Way
City: Stuart State:FL
Zip Code: 34997 Fax: 772-409-8620
Phone N0772-223-8400
E -Mail: brent@onecallflorida.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail brent@onecallflorida.com
State or County LicenseCFC1429700
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:
FRONT
DESIGNER/ENGINEER:
Name:
x Not Applicable
MORTGAGE COMPANY:
Name:
YC Not Applicable
Address:
MANGROVE
Address:
COUNTER
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
V Not Applicable
BONDING COMPANY:
Name:
Not Applicable
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 Countyy 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 INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of 0 ner/ Lessee/Contr�atores.Agent for Owner
STATE OF FLORIDA
COUNTY OF Mad -ii
of
STATE OF FLORIDA
COUNTY OF Martin
The forgging instrument was acknowledged before me The forgoing instrument was acknowledged before me
this f�T day of i 204 by thisday of %4Are kf 20_ft by
[5 ("t MAr1iYI go'e- t' MArtiA
Name of person making statement. Name of person making statement.
Personally Known —I/-- OR Produced Identification
Type of Identification
Produced F Notary Public State of
Tammy Ambroslua
Notary Public- State
No OZ ( v (Seal)
Personally Known,( OR Produced Identification
1wuaaof Identification _
Notary Public Stale cl FWlft
Tommy Ambroolus
My Commission
sio mis2QG S 2"M
Exploo
(Signaturfof Notary Public- State of
No. CiG 2946(06 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. Z///15