HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/21/2019 Permit Number:
COUNTY
>` a it I a
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Commercial Residential X
PERMIT TYPE:Water Heater Change Out
PROPOSED IMPROVEMENT LOCATION:
Address: boi Southeast Gorton
Property Tax ID #. 3A k q — 5 5a - p O59— (pOy — 3 Lot No.8
Site Plan Name: Block No. 66
Project Name:
DETAILED DESCRIPTION OF WORK:
replace existing 40 gal electric water heater in closet
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric
Total Sq. Ft of Construction:
Cost of Construction: $
Plumbing _ Sprinklers
_10o 00
Generator
Sq. Ft. of First Floor:
Windows/Doors
_ Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameJoseph Sexton
Name:James Sinclair
Address: 857 Southeast Corto Court
Company: Mr. Rooter of the TC
City: Port st lucie State: _
Zip Code: 34983 Fax:
Phone No. (772) 359-0497
Address: 534 NW Mercantile PI Suite 119
City: Port St Lucie State: FL
Zip Code: 34986 Fax:
Phone No772-236-7300
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailjames.mrrooter@gmail.com
State or County License CFC 1425604
.. - -- VI IVI1. . .I % wig IJ ylG7VV VI IIIUIC, d I< %-umucu rvoiice or {..ommencement 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:
Zip: Phone
City: State:
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 INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Les ee/Contractor s Agent for Owner
STATE OF FLORIDA f /
COUNTY OF
The forgoing instrument was acknowledged before me
this day of C 2011 by
�hfll S
Name of person making statement
Personally Known V'�__OR Produced Identification
Type of Identification
Produced
1401
�
(Signature of Notary Public- Sta
Commission No.
REVIEWS I FRONT f7rQM
COUNTER I REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev—
Signature of Contractor License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this, -9k day of L 20j�_ by
I( ,os Sl I �LE I f
Name of person making statement
Personally Known i/ OR Produced Identification
Type of Identification
Produced
ature of Notary Public -
KRISTEN L BENSLEY
S
I�ory Public •State of Floi�a mission
Commission #-FF 97040
NS VEGETATION
REVIEW I REVIEW REVIEW
g(STEN L BENSLEY
/PUblic - State of FI
Commission # FF 97041
REVIEW I REVIEW