HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/21/19 Permit Number: �> .
• NOV 2 12019
- - - - --- Building Permit Applicat 99rmitting Drwartrne
Planning and Development Services Lucie County, �L
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential Y
PERMIT TYPE:GAS WATER HEATER
PROPOSED IMPROVEMENT LOCATION:
Address: 2801 KINGSLEY DR.
Property Tax ID#: 1432-806-0021-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
CHANGE OUT 40 GALLON GAS WATER HEATER.
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:$ 500.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name CALVIN C. RICHARDSON Name:CHRIS JOHNSON
Address:2801 KINGSLEY DR Company:CNJ PLUMBING LLC
City: FT. PIERCE State:_ Address:1701 S. 37TH ST.
Zip Code: 34946 Fax: City: FT. PIERCE State:FL
Phone No.772-203-2388 Zip Code: 34947 Fax:
E-Mail: Phone No 772-801-3073
Fill in fee simple Title Holder on next page(if different E-Mail CHRISJOHNSON@FPUA.COM
from the Owner listed above) 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:`}
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: 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 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 INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR L DER OR AN ATTORhfiM BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN .
Signature of Owner/Lessee/Cont actor as Agent for Owner Signature of Contractor/License FL@4er
STATE OF FLORIDA - STATE OF FLORIDA
COUNTY OF COUNTY OF
The fo oing instruent was acknowledged before me The forgoing instrume t as a knowledged before me
this day of VV !'�• 20),by this day of 20M by
Cihr is J,4 n'.wev
Name of person making statement. Name of person making statement.
gs
Personally Known ✓ OR Produced Identification Personally Knowny OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of N ; (Signature of
.....PG AUDREY B.HU HREY O RYPUB` AUDREY B.HUMPHREY
Commission No. '=s MY COMMISSIC ` �300fi'i'1 j`� Commission N cx: MY COMMISSIONIf(�� 817 r
EXPIRES:Mardi 6,2023 Is_} =� �; EXP RES:March 6,20 3
,6F;.W Bonded Thru Notary Public UndaMrrit_re y, �k �' Bonded Thru Notary Public Undenmters l
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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