HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/21/2020 Permit Number:
•
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Commercial Residential x
PERMITTVPE:WATER HEATER REPLACEMENT
PROPOSED IMPROVEMENT LOCATION:
Address: 2800 N HIGHWAY A1A 708 FORT PIERCE FL 34949
Property Tax ID #: 1425-705-0050-000-7
Lot No.
Site Plan Name: BARCLAY BEACH CLUB -PHASE I- UNIT708 (OR 3285-1339)
Block No.
Project Name: CHURLEY WATER HEATER REPLACEMENT
DETAILED DESCRIPTION OF WORK:
REPLACING 30 GAL ELECTRIC TANK STYLE LOW BOY WATER HEATER ON 7TH FLOOR UTILITY CLOSET
SAMEFORSAME
CONSTRUCTION INFORMATION'
Additional work to be performed under this permit — check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_Electric ,K Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 1600.00 Utilities: _Sewer _Septic
_Windows/Doors
_Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ernest E Churley
Name: MATT BLACK
Address:85 Belmont RD
Company: BENJAMIN FRANKLIN PLUMBING
City: Saint John State: Aff
Zip Code: E2M 6K2 Fax:
Phone No.772-871-9494
Address: 1631 SW SOUTH MACEDO BLVD
City: PORT ST LUCIE State: FL
Zip Code: 34984 Fax: 772-871-9069
Phone N0772-871-9494
E-Mail:PERMITS@BENFRANKLINPLUMBER.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail PERMITS@BENFRANKLINPLUMBER.COM
State or County License CFC1430437
a value or mnsrru"ion IS pZJW or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY:_X Not Applicable
Name:
Name:
Address:
Address:
City: State:_
City: State:_
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"YARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE .1MP1{O E, ^� OPERTY. A NOTICE OF COMMENCEMENT MUST W. RDED AND
,
POS '$N THE JOB $LTE BEFORFTI : RST INSPECTION. IF YOU INTEND TO OBTAIN FINAN CONSULT
WNB 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,
COUNTY OF a `ram/_
STATE OF //
COUNTY OF FLORIDA.7
The for6.oIng instrumen s cknowledged before me
20/2(9 by
this¢�day//oyyf/�
The forgoing instrument_wa;acknowledged before me
this¢L day of /�17 20�/by
p� -,
/'!� BI/ 1 �
�j
/J�,IC�4
Name of person making statement.
Name of person making statement.
Personally Known b�' OR Produced Identification
Personally Known _(FOR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signatu f Notary Pub"pike of Florida I
(Signature of Not a ublic-St Of FlOri I
Commission No.
Commission N .
Je'r. Notary Pudic Sete W Florida
Leeli D Oreham
Notary Pudic sere W Florida
F ^�
Commbabn
IhiYa�np
2905n2
aSUPI RVIS R
PLANS
VEGETATI
My Commba
TEPRITelm
WM502
��WANGROVE
CO
REVIEW
REVIEW
EMy
e