HomeMy WebLinkAboutSellards_Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09/28/2020 Permit Number:
�5-n LLFL
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 Residential X
PERMIT APPLICATION FOR: Hot Water heater Change Out
PROPOSED IMPROVEMENT LOCATION:
Address: 9600 S Ocean Drive, Unit 303, Jensen Beach, FL 34957
Property Tax ID #: 4502-620-0012-000-4
Site Plan Name: n/a
Project Name: n/a
DETAILED DESCRIPTION OF WORK:
Like for like Hot water heater changeout. Installing 40 -Gallon, electric, AO Smith water heater.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No._
Block No.
Additional work to be performed under this permit– check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 900.00
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name Robert Sellards
Name: Joseph Brownlow
Address: 9600 S Ocean Dr, Unit 303
Company: Premier Plumbing and Air
City: Jensen Beach, FL State: _
Zip Code: 34957 Fax:
Phone No. 504-701-4568
Address: 108 NE Dixie Hwy
City: Stuart State: FL
Zip Code: 34994 Fax: 772-692-1094
Phone No 772-692-2500
E-Mail:n/a
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail preplbgac@gmail.com
State or County License CFC -1427780
11 Vd1uC ul LVF1bLIUU1Vn IS L:)uu or more, a KtL.VKUtU Notice OT LAmmencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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 revte�N your deep for ar,y restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree tf,at i will; in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes ane 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 NOTIPE-PIF COMMENCEMENT."
� .! 11� 1
Signatur o wnerj Lessee/Contractor as Agent for Owner
STATE OF FLORIDA�,
COUNTY OF lr
The forgoing instrurpent wa5 acknowledged before me
thisoday of 20.-;�Oby
10 S
Name of persoh making statement.
Personally Known X OR Produced Identification _
Type of Identification
Produced
n
(Sign ture of Notary Pu ST •.•::F
Commission # GG 208194
Commission No. 1F&11
22
My
REVIEWSI FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
Signatgire of Contractor/License Holder
STA OF FLORIDA°
COUNTY OF • Z U C'e__
The forgoing instrum�q was rknowledged before me
thisZe day of 20 Way
W1 Ui
Name of person aking statement.
Personally Known �_ OR Produced Identification
Type of Identification
Produced
najure of Notary Public- S
mission No.
I oY (fii' •, APRIL BRUMLEY
Commission # GG 20E
Apd 17,2M
oi�
-Ful 2• W Tina Troy Fain ha
ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_
Not Applicable
Name:
Narne:
Address:
Address:
City:
State:
City: State:
I Zip: Phone
Zip: Phone:
i
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 revte�N your deep for ar,y restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree tf,at i will; in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes ane 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 NOTIPE-PIF COMMENCEMENT."
� .! 11� 1
Signatur o wnerj Lessee/Contractor as Agent for Owner
STATE OF FLORIDA�,
COUNTY OF lr
The forgoing instrurpent wa5 acknowledged before me
thisoday of 20.-;�Oby
10 S
Name of persoh making statement.
Personally Known X OR Produced Identification _
Type of Identification
Produced
n
(Sign ture of Notary Pu ST •.•::F
Commission # GG 208194
Commission No. 1F&11
22
My
REVIEWSI FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
Signatgire of Contractor/License Holder
STA OF FLORIDA°
COUNTY OF • Z U C'e__
The forgoing instrum�q was rknowledged before me
thisZe day of 20 Way
W1 Ui
Name of person aking statement.
Personally Known �_ OR Produced Identification
Type of Identification
Produced
najure of Notary Public- S
mission No.
I oY (fii' •, APRIL BRUMLEY
Commission # GG 20E
Apd 17,2M
oi�
-Ful 2• W Tina Troy Fain ha
ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW