HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/10/19 Permit Numb ar:__J=qiJ1.Q9A_
R1 E ILIC
A- DEC 10 2019
Building Permit Application
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County, FL
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: 5120 OLEANDER AVE
Property Tax ID . 3403-322-0002-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF"WORK:
CHANGE OUT 40 GALLON GAS WATER HEATER TO TANKLESS 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 DANIEL A. NELSON Name:CHRIS JOHNSON
Address:5120 OLEANDER AVE. Company-.CNJ PLUMBING LLC
City: FT.PIERCE State: Address:1701 S. 37TH ST.
Zip Code: 34982 Fax: City: FT. PIERCE State:FL
Phone No.772-461-5503 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
L
If value of construct'ion 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.
SUPPLEftt�EN AL CaNST�UCTION1.4 LAW}[NFORINIATIQ 1 • �� f ' _` '
v_;::-:_
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,
accessoryy 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 BEFO E THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FIN CING, CONSULT
WITH YOUR L DER OR ANA NEY BEFORE RECORDING YOUR NOTIC F COMMENCEM "
1.11
nature of Owner/LessecKontrktor as Agent for Owner Signature of Contractor/License older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The fgrgoing instrument was acknowledged-before me The fgrboing instr ent was acknowledge
pefore me
this U day of 20 by this / day of 20 Lt by
C ,-To
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 Produced
0
(Signature of Notaryublic-State of Florida) _ U (Signature of Nota ublic-State of Florida) '
s AUDREY B.H P EY
Commission N ;'�."P B'
v• Commissi N �P� pt DEFY R.HUMPHR&a I)
MY MISSIO #� 300817 `
MY COMMISSION l#GG 300817
a EXPIRES:March 6,2023
odi°•
Bonded Thru Notary Publi-zU,merwfacm, i5
oer�t;:
5ff „-�- SO -,—
> .,ended Th u Notary Public Undenvrit as
REVIEWS 1r1"'� 1G SUPERVISOR PLANS - _. NGROVE
ss
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
'RECEIVED
DATE
COMPLETED
ev.2/7/19