HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/7/19 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 Residential Y
PERMITTYPE:GAS WATER HEATER
PROPOSED -IMP
-ROVEMENTLOCATION:;
Address: 3206 ANDERSON DR.
Property Tax ID #: 1432-807-0014-000-8
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
CHANGE OUT 40 GALLON GAS WATER HEATER.
CONSTRUCTION INFORMATION:
Lot No.
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: _
Cost of Construction: $ 500.00
Sq. Ft. of First Floor: _
Utilities: —Sewer —Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR;
Name AGNES T. MOORE
Name: CHRIS JOHNSON
Company: CNJ PLUMBING LLC
Address: 3206 ANDERSON DR.
City: FT. PIERCE State: _
Zip Code: 34946 Fax:
Phone No. 772-409-4413
Address: 1701 S. 37TH ST.
City: FT. PIERCE State: FL
Zip Code: 34947 Fax:
Phone No 772-801-3073
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail CHRISJOHNSON@FPUA.COM
State or County License 30950
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.
'LEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:_
Address:
City:_
Zip:
Phone:
Not Applicable
State:
Not Applicable
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 T E JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTE TO OBTAIN F1NA1Q1NG, CONS T
WITH YOURANDER OR AN ATTORNO BEFORE RECORDING YOUR NOTI OF COMMENCE
.Sfn-ature of Owner/ Lessee/Co ctor as Agent for Owner
Signatdr4of Contractor/License Holder
STATE OF FLORIDA \
STATE OF FLORIDA
COUNTY OF ,C ,
COUNTY OF
The for oing instrument was acknowled before me
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The forgoing instrument was acknowledged before me
f1 20_6 by
this day of . 2 by
this day of D(-%:
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
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Stat of Florida)
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Commission No.
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