HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/11/2020 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 x Residential
PERMIT TYPE: Water Heater Replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 1VUa0 UJ r1Wy I, r'JL:54y5"L
Property Tax ID #: 3414-501-3715-050-9
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Remove and replace 80 gallon electric water heater.
Lot No.
Block No.
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit–check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters -Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 1940
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Salon Centric
Name: Adam Sampson
Address: 10036 US Highway 1
Company: Southpaw Plumbing and Metering Service, LLC
city: Port St. Lucie State: _
Zip Code: 34952 Fax:
Phone No.
Address: 1458 SW Bartell Ave.
city: Port St. Lucie State: F
Zip Code: 34953 Fax: 772-324-6531
Phone No 772-486-0914
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail info@ south pawwater. com
State or County License CFC1428285
.a...� .. w« U...D �1aaw o. more, a nct.UKUrU Notice oT wmmencement 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:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 RECON 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/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE STATE OF FL
COUNTY OF F FLO pA � i \C\ � COUNTY OFOv t RC1`
COUNT
The for oing instr n was acknowled ed before me
this, day of 20J) by
vv\ r 1,-,
Name of person making sstatement.
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
(Signature of Noffiry ' -
Commission No.
1 6
REVIEWS FRONT
COUNTER
DATE
SSION M GG 022031
September 11, 2020
ZONING I SUPERVISOR
REVIEW I REVIEW
The for nstr 1 nt was acknowled a before me
this day of 20aC, by
Name of person makings temen .
Personally Known OR Produced Identification
Type of Identification
Produced
S SARA JQ'
600*01'
PLANS � REVI W VEGETATION ANGRO
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