HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I — I P ` 2-02-0 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) 462-1.578 Commercial Residential e
PERMIT TYPE:water heater replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 8943 Champions Way
Property Tax ID #: 3334-501-0037-000-1
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace existing 50 gal. electric water heater in garage
CONSTRUCTION INFORMATION:
Lot No. 23
Block No. A
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:
Cost of Construction: $ 900.
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Martin Desrochers
Name:James Sinclair
Address: 8943 Champions Way
Company: Mr Rooter of the Treasure Coast
City: Port St Lucie State: _
Zip Code: 34986 Fax:
Phone No.
Address:534 NW Mercantile PI Suite 119
City: Port St Lucie State:
Zip Code: 34986 Fax:
Phone N0772-236-7300
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailjames.mrrooter@gmail.com
State or County License CFC 1425604
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
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: T Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City:
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 Counter 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 SCI'E BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
11 0'/;
Signal e of Owner/ Lessee/Contractor as Agent for Owner I Signatifre of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF !SL_ LuL.i-e_ COUNTY OF 54:. LuGe 5.—
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 10 day of )2nugAr,r 202.Oby this 10 day of .30_rKrg 20?jL')by
Ca YTf-_5, St nC IGE-.. r7► CAtM S L Y l C 1 fly
Name of person making statement. Name of person making statement.
Personally Known ICOR Produced Identification
Type of Identification
Produced
(Signature of Notary Public -
Commission No FF
REVIEWSi FRONT
I COUNTER
DATE
RECEIVED
DATE
COMPLETED
ttRI$TEN L BENSLI
Wry POk - State of
Commission # FF 97
,Comm. Expires Mar i
Personally Known i-�_ OR Produced Identification
Type of Identification
Produced
re of Notary Pub
scion No.
ZONING I SUPERVISORI PLANS VEGETATION I SEATURTLE
REVIEW REVIEW REVIEW REVIEW REVIEW
RrstsTEN L SENS
Notary Public - State,
'}Commission FF 9
Iy Comm. Expires Mar
MANGROVE
REVIEW