HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and DevetopmentServices
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT TYPE: Water Heater Replacement
E
Address: 5201 Hickory Drive
Property Tax ID H: 3402-608-0425-000-4
Site Plan Name:
Project Name:
Install 40 gallon electric water heater
Lot No. 31
Block No. 51
Additional work to be performed under his permit– check all that apply:
_Mechanical _Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric ' f/Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 600.00 Utilities: —Sewer _Septic Building Height:
Name Myron Wilson Name: Wade Case
Address: 5201 Hickory Drive Company: Lindquist Plumbing
City. Ft. Pierce State: _ Address: 3185 Sneed Road
Zip Code: 34952 Fax: City: FT. Pierce State: FL
Phone No. 772-332-1934 Zip Code: 34945 Fax: 772-461-1999 .
E -Mail: Phone No 772-461-1969
Fill in fee simple Title Holder on next page ( if different E -Mail lindquistplumbingcompany@gmail..com
from the owner listed above) State or County License CFC1428458
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.
Nit'
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DESIGNER/ENGINEER:
Name:
Address:
City:
Not
Applicable
MORTGAGE COMPANY:
Name:
Address:
Not Applicable
State:
City:
Zip: Phone:
State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
_ Not Applicable
BONDING COMPANY:
Name:
Not Applicable
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 comenced prior to the issuance of a permit.
St. Lucie County makes no representation tha3Tis granting a permit will authorize thepermit 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 reques#ed 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 BEFOREITHE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTOR EY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF si.Luae
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 6 day of September 20 by this 6 day of September 120 by
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
jjw�/
(Signature of Notary Public t� M INarie Lovejoy rignatureof Notary Public- 5 t i ry Public State of Plvrid,
My Lommission GG 355643 Enn Marie Lovejoy
GG 355643q t apt l}JIt6l2023 yCsion GG 355543
Commission No. IYeat n NO. GG 355643 �� oJr',"31223
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RECEIVED
DATE
COMPLETED
FRONT I ZONING I SUPERVISOR
j REVIEW I VREVI WON S REV EWLE I MREV �WVE
COUNTER REVIEW