HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1111112019 Permit Number:
COU"t
r_. L n.;:i
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: water heater
PROPOSED IMPROVEMENT LOCATION:
Address: 5214 Birch Dr, Fort Pierce, FL 34982
Property Tax ID #. 3402-608-0409-000-6
Site Plan Name:
Project Name:
Building Permit Application
Commercial Residential X
DETAILED DESCRIPTION OF WORK:
install 38 gallon AO Smith electric water heater�-
CONSTRUCTION INFORMATION:
Lot No. 15
Block No. 51
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: $ 650.00
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name John Russ
Name: Joseph Tully
Address: 5214 Birch Dr
Company: Genesis Plumbing Services
City: Fort Pierce State: _
Zip Code: 34982 Fax:
Phone No. 772-577-0014
Address: 1532 SE Village Green Dr. Unit B
City: Port St Lucie State: FL
Zip Code: 34952 Fax: 772-335-2680
Phone No 772-337-3682
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail genesisplumbingservices@gmail.com
State or County License CFC1429103
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' _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE MOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
Signature of Owne_rj se27Contractor as Agent for Owner
STATE OF FLORIDA,_.,
COUNTY OF
The for ing instrument was acknowledged efore me
this day of 20by
(Name of person acknowledging )
{SignatuV6 6f'Notary Public- State of Florida )
Personally Known :%`Y"%i PrBdilfdbei#fF�Z
Type of Identificati r Commission # GG 97156
y ommissfon x
'r:;'IF Aprl Zd 2021
Commission No. """'"`
Revised 07/1512014
REVIEWS FRONT I ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
mature of Contractdr/License-Rnlder
STATE OF FLORIDA
COUNTY OF
The for giAg instru ngt was acknowledged efore me
I
his day of i V 'C �,' 20 by
(Name of person acknowledging j
of Notary Public State of Florida }
Personally Known - ,«",':' R Prc4MXA99teJANiEAQffZ
Type of Identificati'o 0Commission # GG 97150
�= My Commission xp4e
Commission No. '%:," 0 11 April 021
SUPERVISOR �PLANS � VEGETATION � SEATURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW