HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/1512019 Permit Nui
Cour,
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
PERMITTYPEMATER HEATER REPLACEMENT
PROPOSED IMPROVEMENT LOCATION:
Address: 7251 GULLOTTI PL PORT ST LUCIE FL 34952
Property Tax ID If: 3414-501-1009-100-9 Lot No.9f11
Site Plan Name: Block No. 2
Project Name: SEIDEN WATER HEATER
DETAILED DESCRIPTION OF WORK:
REPLACING 50 GAL LP GAS WATER HEATER IN GARAGE WITH SAME 50 GAL LP TANK STYLE WATER HEATER
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
Electric ZPlumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 2000.00 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameAlan Seiden
Name: Robert Ludlum
Address:7251 Gullotti PI
Company: Benjamin Franklin Plumbing
City: Port St Lucie State: _
Zip Code: 34952 Fax:
Phone No.772-871-9494
Address: 1631 SW South Macedo Blvd
City: Port St Lucie State: FL
Zip Code: 34984 Fax: 772-871-9069
Phone N0772-871-9494
E-Mail: permits@benfmnklinplumbing
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail PERMITS@BENFRANKLINPLUMBER.COM
State or County LicenseCFC1426801
IT value Of conscruRron 6 >eauu or more, a Ntconutu 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:
Name:
x Not Applicable
MORTGAGE COMPANY:
Name:
X Not Applicable
Address:
Address:
City:
Zip: Phone
State:_
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name;
A 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 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 OBT CING, CONSULT
WITH YOUR LENDER OR AN ARORNEY BEFORE RECORDING YOUR NOTICE 06CO ENT."
Signatun cone s e ractor as Agent for Owner
Signature of ontractor/Lice se Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ,5f'�+ar'e..
COUNTY OF S/
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of jul 20-1by
this day of 20-d by
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Name of person making statement.
Name of person making statement.
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Personally Known XOR Produced Identification
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Type of Identification
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Produced
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