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Date:. ((l2J Itel 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
PERMITTYPE:TANKLESS WATER HEATER REPLACEMENT
PROPOSED IMPROVEMENT LOCATION:
Address: 12770 NW MARINER CT, PALM CITY, FL 34990
Property Tax ID #: 4425-603-0009-000-1 Lot No.
Site Plan Name: HARBOUR RIDGE -PLAT 4- TRACT B (OR 4136-1284) Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
INSTALL RINNAI LP GAS TANKLESS WATER HEATER IN 2ND FLOOR HALLWAY CLOSET.
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: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name David C Hill (TR)
Name: ROBERT W. LUDLUM
Address: 12770 NW MARINER CT
Company: BENJAMIN FRANKLIN PLUMBING
City: PALM CITY State: FL
Zip Code: 34990 Fax: WA
Phone No. 7728719494
Address: 1631 SW SOUTH MACEDO BLVD
City: PORT ST LUCIE State: FL
Zip Code: 34984 Fax: 7728719069
Phone Nc7728719494
E -Mail: Vjry
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail PERMITS@BENFRANKLINPLUMBER.COM
State or County License CFC1426801
If value of construction Is $2500 or more, a RLLDRULU Notice or Commencement Is requlreo.
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 Count makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an 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.
Inconsideration 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 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 INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDERIOR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
WinatUrE of Oafner/ Lessee/Contractor as Agent Tor owner mature Or},omractor/License noir er
STATE OF FLORIDA STATE OF FLORIDA /•,
COUNTY OF 4r LuP./� COUNTY OF ao'. -
The forgoing instrument was acknowledged before me
this Y,9 day of lllh! .20[Z by
Name of person making statement.
Personally Known _I OR Produced Identification
Type of Identification
(Signature of No .w I to
1 Y��rrC�NI9SItNI K D0065�95
Commission No. R1IItE9 a95lIhY 28. 2031
The forgoing instrum nt was acknowledged before me
this,?12dayof✓ 201!�2!by
"fns 7'- it /C%/'" -
Name of person making statement.
Personally Known _—ZOR Produced Identification
Type of Identification
(Signature of Notary
Commission No.
REVIEWS COUNTER REVIEW SUPERVISOR
R I REV EW NS I REVIEW
W 491l"SSION M ptlwfM
EXPIRES January 15.1031
SEATURTLE I MANGROVE
REVIEW I REVIEW