HomeMy WebLinkAboutSLC Building Permit - MitcheltreeAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/8/2020 Permit Number:
ST. LUCIE
COU NT'Y
F L O 1 10
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) 462-1578
Commercial
PERMIT APPLICATION FOR:Water Heater Replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 14Ur a gain zareei, r-orl rlerce, I-L 34950
Property Tax I D #: 2417-704-0017-000-9
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Residential x
Lot No.
Block No. _
Remove existing water heater and replace with new water heater located in back of house
New Electrical Meter Second Electrical Meter
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
Total Sq. Ft of Construction: 1,439 Sq. Ft. of First Floor:
Cost of Construction: $ 1213.74 Utilities: —Sewer —Septic Building Height:
W-1
Pitch
OWNER/LESSEE:
CONTRACTOR:
NameMax Mitcheltree
Name Adam Sampson
Address:2207 S 39th Street
Company:Southpaw Plumbing and Metering Servi(
Address:1458 SW Bartell Ave.
City: Fort Pierce State: _
Zip Code: 34947 Fax:
Phone No.772-940-4335
City: Port St. Lucie State -FL
Zip Code:34953 Fax: 772-324-6531
Phone N0772-486-0914
E-Mail:lynnemariemitcheltree@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mailinfo@southpawwater.com
State or County LicenseCFC1428285
u�.a you or more, a Ktcvnueu Notice oT commencement is required.
If value of HAVC 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 Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before commenring wnrk or rPrnrriinc un, it Nn+iro f rnmmcnramen+
Signature of Owner ssee/Contractor as Agent for Owner
Signature of Contra License Holder
STATE OF FLORIE 7
STATE OF FLOFll!! (�
COUNTY OF \�� `>f F
COUNTY OF .1' \ VAX,\ e
Swo o (or affirmed) and subscribed before me of
Swor o (or affirmed) and subscribed before me of
_ Ical Prese ce r Online Notarization
this day T
ical Pres ce r Online Notarization
of 2020 by
this day of 2020 by
n
Name of person making statement.
Name of person making stat ent.
-tent.
Personally Known -/ OR Pr
nown
w:t, •• SARA701MO
Type of Identification ;,jiti ";•;
tification ..., •.,'
Produced _ . :,= MY COMMISSION#G
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_ COMMISSION GOG 022030
o`' EXPIRES: September
September 11. 2020
Notary PubicU
.�¢.• Bonded Thru Notary Pubio Underxnters
(Signature of Not ry Pu lic-State of Florida)
(Signature of Nota y Pubic- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
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