HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/15/2019 Permit Number:
, 111111111111111110 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 TYPE: Plumbing
PROPOSED IMPROVEMENT LOCATION: Garage
Address: 7710 Greenbrier Cir - Port St Lucie, FL 34986
Property Tax ID #: 3322-700-0031-000-3
Site Plan Name:
Project Name: Water Heater Tank Change Out
Lot No. 26
Block No.
DETAILED DESCRIPTION OF WORK:
Replace failed electric tank -style water heater with AO Smith 50 gallon electric tank -style water heater in garage.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit – check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric dumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 1900.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ronald P. Keeley & Ethel S. Keeley
Address: 7710 Greenbrier Cir
City: Port St. Lucie State: '
Zip Code: 34986 Fax: n/a
Phone No. 772-871-9494
Name: Robert W. Ludlum, Jr.
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: n/a
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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.
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 COMMENCEMENTT BE RECORDED AND
POSTED ON THE JOB SIT RE THE FIRST INSPECTION. IF YOU INTEND T AIN FINANCING, CONSULT
WITH YOUR LE DE R TTORNEY BEFORE RECORDING YOUR CE OF O ENT."
Sig 0 r/ essee/Contractor as Agent for Owner
Sign re of Conetractor/LicensHolder
OY e�
STATE
OFORIDA
COUNTSTATE
G4�Ge�`/�/
COUNTOY OFORIDAf/C��%'
The forgoing instrument yvas ack owledgeefore me
this ray of 20 bythis
The forgoing instrumen was ac nowledge�efore me
fday of 20 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification 4µY6,,.,
Type of Identification
Produced :t' MARIO L HERNANDEZ
Produced
MY COMMISSION # G0066496',4
XPIRES Janus ry se. 202
- ._ ?kpE
(Signature of Notary Public- State ofto)ida)
(Signature of Notary Pub is • . �f Fle�o
Commission No. (Seal)
, S Jai
Commission No.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.