HomeMy WebLinkAboutPERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: APRIL 22, 2020 Permit Number:
_t
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 x
PERMITTYPE:WATER HEATER REPLACEMENT
PROPOSED IMPROVEMENT LOCATION:
Address: 113 SE CAMINO STREET
Property Tax ID #: 3419`515-0248-006-6
Site Plan Name: DONALD MOUILLESEAUX
Project Name: REPLACE HOT WATER HEATER
DETAILED DESCRIPTION OF WORK:
REPLACE SHWH W/ 50 GAL RHEEM WARRANTY
Lot No. 12
Block No. 29
-- ------ - -- --, - .-.. -,. _ ......W!. , a nU_i.vrcuru rvvuce or Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
CONSTRUCTION INFORMATION:
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: $ ) Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name DONALD MOUILLESEAUX
Name: ROBERT C. TRYON
Address: 113 SE CAMINO STREET
Company.TRYON PLUMBING INC
City: PORT ST LUCIE Stater
Address:925 WAGNER PLACE
Zip Code.. 34952 Fax:
City: FT PIERCE State: FL
Phone No. 772-266-4887
Zip Code: 34982 Fax.
E -Mail:
Phone No
Fill in fee simple Title Holder on next page ( if different
E -Mail TRYONIO@AOL.COM
from the Owner listed above)
State or County License CFC058068
If value of rnnctr... tin Cc d irnn
-- ------ - -- --, - .-.. -,. _ ......W!. , a nU_i.vrcuru rvvuce or 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
MORTGAGE COMPANY: _ 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
"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 COMMENC.lE_MENT."
Signature of Owner/ Lessee/Contractor as Agent Owner
STATE OF FLORID
COUNTY OF - lAACice,
The forgoing inst ument'wa acknowledged before me
this,_ day of `iA LA 20'=_�Cby
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
vyulu"t(Signature ary Pu ic- State of F o da )
Commission No.
(Seal)
Signature of Contractor/License Holder
STATE OF FLORI
JDA
COUNTY OF L_ ,k 0 3 ,
The forgoing instrument was a knawledged before me
this day of '� f _ 2�by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
Signature o ry Pu ic- State of n
Ida ]
Commission No.
(Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
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DATE
RECEIVED
DATE
COMPLETED
Rev. 21 // 19