HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 /22/20
•
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: PLUMBING
PROPOSED IMPROVEMENT LOCATION:
Address: 2050 Tilton RD Port St Lucie, FL 34952
Property Tax ID p: 3414-501-0514-400-8
Site Plan Name:
Project Name: WATER HEATER
DETAILED DESCRIPTION OF WORK:
Permit Number:
Building Permit Application
Commercial Residential X
55 - GALLON ELECTRIC WATER HEATER REPLACEMENT
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Lot No.
Block No.
_Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 1,749.00
Sq. Ft. of First Floor:
Utilities: —Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Andrew D Lonabaugh
Name: RICHARD BASSOFF
Address: 2050 Tilton RD
Company: ADMIRAL PLUMBING SERVICES, LLC
City: PORT SAINT LUCIE FL State: _
Zip t,ode: 34952 Fax:
Phone No. 856-904-1944
Address; 2695 JUPITER PARK DR STE 700
City: JUPITER; State: FL
Zip Code: 33458 . Fax:
Phone No 561-746-1180
E-Mail: andrewlonabaugh@yahoo.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail PERTMITTING@THEADMIRALPLUMBER.COM
State or County License CFC-1426115
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:
MORTGAGE COMPANY: _ Not Applicable
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Address:
0.3
_Not Applicable
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 priorto the issuance of a permit.
St. Lucie Counttyy 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Con actor a n or Owner
Signatur ontractor/License H er
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF PALM aEACH
COUNTY OF PALM BEACH
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 22 day of JAN , 20_ by
this 22 day of JAN 20_ by
RICHARD BASSOFF
RICHARD BASSOFF
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Pro,duced_h
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Produced
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REVIEWS
FRONT
RVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
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REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19