HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/9/2020 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 xxxxxxxxxx
PERMIT TYPE: PLUMBING HEATER REPLACEMENT
..PROPOSED IMPROVEMENT LOCATION:.. _.:..,.;.,.....;.
Address: 8264 MARTINGALE LANE PORT ST LUCIE FL. 34986
Property Tax ID #. 3328-701-0005-000-3 Lot No. 152
Site Plan Name: SABAL CREEK PHASE IV Block No.
Project Name: MICHAEL BRANTLEV RESIDENCE
DE AILED DESCRIPTION OF WORK:
REMOVE AND REPLACE IN SAME LOCATION 50 GALLON ELECTRIC WATER HEATER
REMOVE AND REPLACE IN SAME LOCATION 80 GALLON ELECTRIC WATER HEATER
CONSTRUCTION INFORMATION°
Additional workto be performed underthis permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_Electric _plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: N/A Sq. Ft. of First Floor: NIA
Cost of Construction:$ 2200.00 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE::;" CONTRACTOR: JIM
Name MICHAEL C BRANTLEV Name: ROBERT LUDLUM
Address: 8264 MARTINGALE LANE Company: AQUA DIMENSIONS PLUMBING Svcs.
City: PORT ST LUCIE State: _ Address: 1651 SW SOUTH MACEDO BLVD
Zip Code: 34986 Fax: City: PORT ST LUCIE State: FL
Phone No. Zip Code: 334984 Fax: 772-343-7418
E-Mail: Phone No 772-344-8433
Fill in fee simple Title Holder on next page ( if different E-Mail ADPS@AQUADIM ENSIONS.COM
from the Owner listed above) State or County License CFC057526
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:
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 County makes no representation that is granting a permit will authorize the permit holderto 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.
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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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nature of er/ sse ontractor as Agent for OwnerSignature
of a or/License Holder
STATE OF FLORIDA
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The forgoing i A=oem was acknowledged before me
The forgoing ent was acknowledged before me
this 0. day dif m� 20aa by
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Name of person making statement.
Name of person making statement.
Personally Known 1� OR Produced Identification
Personally Known Y OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary _y _fIEIP dISS10NA GG05872
(Signature of Notary t OM1II�Ar �r[SSION If GG058720
Commission No. GG 0 EXPIRMS anuary08,2021
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/' EXPIRES January 08,2021
Commission No. l_3 •• � (Seal)
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