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DESIGNER/ENGINEER: � N'ot Applicable
Name:
MORTGAGE COMPANY: _Not Applicable
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 thepermit holder to build the subject structure
which is in conflict with any applicable Horne 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 ars 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 ITO 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 BEFOREI THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
i
Signature of Owner/ Lessee/Contractor as Agent
for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 5t. Lucie
COUNTY OF SL Lucie
The forgoing instrument was acknowledged
before me
The forgoing instrument was acknowledged before me
this 9th day of September 20_
by
this 9th day of 5eptemebr �0— 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
(Signature of Notary Pu tic-
Notary Public State of Florida
Commission No. �:. arie Love'
+�c s My Com isswn GG 355643
Exp#ras0711612023
gnature of Notary P -
40 N Pub is State of Florida
Erin Mai L ejoy
mmission No. G My Cam GG 355643
a* Expires 07118/2023
REVIEWS FRONT ZONINGSUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
All APPLICABLE INFO MUST BE COM
Date:
FOR APPLICATION TO BE ACCEPTED
Permit Number:
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
PERMIT TYPE: Water Heater
Address: 6156 Santa Margarito Drive
Property Tax ID ##. 1312-501-0027-000-4
Site Plan Name:
Project Name:
Install new 50 gallon water heater
Residential x
Lot No. 92
Block No.
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric Plumbing _ Sprinklers ` Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 700.00 Utilities: —Sewer _Septic Building Height:
Name Beverly Malinowski Name: Wade Case
Address: 6156 Santa Margarito Drive Company: Lindquist Plumbing
City: Ft. Pierce State: &L• Address: 3185 Sneed Road
Zip Code: 34951 Fax: City: FT. Pierce State: FL
Phone No. 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 CFC 1428458
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.