HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 07/08/2019 Permit Number:
S .i
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 REPLACEMENT I
2813 S BROCKSMITH ROAD FORT PIERCE FL 34945
Property Tax ID 1f: 2320-501-0042-020-3 Lot No. 12
Site Plan Name: SUBDIVISION OF MC NURLEN FARMS BLK 3 LOT 12(9.59 AC. 417,740.50 SF)(OR 3727-126) Block No.3
Project Name: HARKCOM WATER HEATER REPLACEMENT
DETAILED DESCRIPTION OF WORK:
REPLACING LEAKING WATER HEATER WITH 50 GAL ELEC TANK STYLE WATER HEATER
LOCATED IN THE LAUNDRY ROOM
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_Electric ,Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction _
Cost of Construction: $ 700.00
NameJeffrey F Harkmm
Address:2813 S BROCKSMITH ROAD
City: FORT PIERCE State:
Zip Code: 34945 Fax:
Phone No.
Sq. Ft. of First Floor-
—
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
f value of construction Is $2500 or more, a RECORDED Notice
Name: ROBERT LUDLUM
Company: BENJAMIN FRANKLIN PLUMBING
Address: 1631 SW SOUTH MACEDO BLVD
City: PORT SAINT LUCIE State: FL
Zip Code: 34984 Fax: 772-871-9069
Phone No772-871-9494
E-MailPERMITS r@BENFRANKLINPLUMBER.COM
State or County LlcenseCFC1426801
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
J� Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:_
FEE SIMPLE TITLE HOLDER:
Name:
Il 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 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 an 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
'%YARNING 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 FlNA91CINC, CONSULT
WITH YOUR LENDER ORAWATTORNEY BEFORE RECORDING YOUR NOTICE OF COMNENCERtOW.
1
Signal o Contractor Lice older
S IIr 1 essee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFsTcucie
COUNTY OFa*wae
The for oing instrumen wa acknowledged before me
The for ing Instrumen w s acknowledged efore me
today
this day of 201j by
this of 204f by
Name of person making statement.
Name of person making statement.
Personally Known z,1 OR Produced Identification
Personally Known C---OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signat of Notary blic- State orida I
zfission
(Signature off/ tary Public- to o orida I
Co No. N0Y
Commissions No.
Laski D Graham
Notary Public sale a Fkv4W
w Eapaes 01
W3Mcoinnv
d
�
REVIEWS
FRO
PLANS
t
VEGETATI �w AlPORTELM
ANGROV
COUNTER
REVIEW
REVIEW
DATE
77
RECEIVED
DATE
COMPLETED
Rey. 2///19