HomeMy WebLinkAboutBuilding Permit Application 01/03/2020 16:09 FAX IM001/005
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/03/2020 Permit Number:
RECEIVED
JAN 0 6 -`)
Building Permit Application
Lucie�t
Planning and Development Services ST, -HntyI Permittinc_.
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential x
PERMITTYPE:WATER HEATER CHANGE OUT
Address: 5169 N HIGHWAY A1A 414 FORT PIERCE FL 34949
Property Tax ID#: 1411-706-0018-000-1 Lot No.
Site Plan Name: OCEAN HARBOUR CONDOMINIUM B-UNIT 414 AND UNDN SHARE IN COMMONELEMENTS(OR 1880-1742;3720-1842) Block No.
Project Name: WATER HEATER REPLACEMENT
Replace water heater 30 gallon electric lowboy in utility closet
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:$ 1600.00 Utilities: —Sewer _Septic Building Height:
Name,lames F Dwyer Name:Matthew Black
Address:408 SW Locust CV Company:Benjamin Franklin Plumbing
City. Port St Lucie State: Fl. Address:1631 SW South Macedo Blvd
Zip Code: 34986 Fax: City: Port St. Lucie State:FL
Phone No. 772- 87/-99i� Zip Code. 34984 Fax: 772-871-9069
E-Mail:Permits@benfranklinplumber.com Phone N0772-871-9494
Fill in fee simple Title Holder on next page(if different E-Mail Permits@benfranklinplumber.com
from the Owner listed above) State or County License CFC1 430437
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.
01/03/2020 16:10 FAX 1@002/005
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: xNot 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 thepermit 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 OWNEIE YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TRICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED N T JOB SR IBEFO�W9-FUMT INSPECTION. IF YOU+7NTEND'TO O-gTA1N•F7 XdNC, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA // /- u-.
COUNTY OF _n'4 .Gc�c�G- COUNTY OF �SY' /W L
The forgoing instrument was acknowledged before me The forgoing instrument as acknowledged before me
this-3 day of .rct-�! ,20 W by this day of 20 / by
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
(Signature otary Public- ate Florida) (Signature of Not Public-S e of orida)
Commission No. Commission No.
Notary Pu r,State of Florida Notary Public State of Florida
;� Lest D Graham lz�
* Empires 0113012 3 4{y Commission GG 299502
2
REVIEWS F w PLANS VEGETA a EAE 1Ea0� zl�/IANGRO
COUNTER REVIEW REVIEW REVIEW REVIE10
DATE
RECEIVED
DATE
COMPLETED
ev.2/7/19