HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10 11 col I q Permit Number:
'�.N;
COUNTY
i
L
O R I D A
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
PERMIT TYPE: Plumbing -Water Heater Replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 544 Paurotis Lane, Fort Pierce, FL 34982
Property Tax ID #: 3410-503-0244-000-4
Site Plan Name:
Project Name:
Lot No. 3
Block No.
DETAILED DESCRIPTION OF WORK:
Water heater removed and replaced with a 40 gallon electric water heater located in the garage.
CONSTRUCTION INFORMATION:
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: $ 1000.00
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Doris Babkes
Name: Adam Sampson
Address: 544 Paurotis Lane
Company: Southpaw Plumbing and Metering Services, LLC
city: Fort Pierce State: _
Zip Code: 34982 Fax:
Phone No.
Address: 1458 SW Bartell Ave
City: Port St. Lucie State: F
Zip Code: 34953 Fax:
Phone No 772-486-0914
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail info@southpawwater.com
State or County License CFC1428285
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ 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 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 INTENP TO OBTAIN FINANCING, CONSULT
WITH Y UR LENDER OR AN TTORNE EFORE RECORDING YOUR NOTIC F COMM MENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLO A 1 ,
STATE OF FLO!T , • •
COUNTYOF U �e \�
COUNTYOF \ l�\l
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The f r o�.instru en was ackno pledged before me
this�dayof.�20 R by
The fQQr��gqi��l1��instrujge t was
this��Q?layof V
cknowl dg before me
20- by
Name of person making s tement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known �OR
Produced Identification
Type of Identification
Type of Identification
Produced
Produced
V
(Signature of Wtajtbijsta
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ture of No a P lic
t ! {lorida ) SARAJOHNSON
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•�• _ COMMISSION #G0022030
Commission No.3e$'I
COMMISSION#GG0
6lu ission No.
t 11,
FTJ@ Glary
o • EfPIRES: Se fember 11,
P
2 20
Pubic U rater
.,,o.. �$.•'B Thru WyPubYc Urbererilers
Bonded Thru Notary Public U"
Yens
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19