HomeMy WebLinkAboutPermit App - WH Change-out NotarizedAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Water Heater Change Out
PROPOSED IMPROVEMENT LOCATION:
Address: 7071 TORREY PINES CIR
Residential X
Property Tax ID #: 3322-504-0061-000-0
Site Plan Name: POD 713 REPLAT AT THE RESERVE PUD I TORREY PINES LOT 50D
Project Name: Water Heater Change Out
DETAILED DESCRIPTION OF WORK:
Lot No.50D
Block No.
REPLACEMENT OF 50-GALLON ELECTRIC WATER HEATER, LOCATED IN THE GARAGE
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical —GasTank —Gas Piping _ Shutters
Electric Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1053.00
Sprinklers _ Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Jean Lacasse, Josee Couillard
Name: KLIMENT STEFANOV
Address:133 Labelle St
Company: KINTEX PLUMBING, LLC
City: Chateauguay, QC (Canada) State: _
Zip Code: J6K 4X3 Fax:
Phone No.910-501-9855
Address: 2880 W OAKLAND PARK BLVD, SUITE 200
City: OAKLAND PARK State: FL
Zip Code: 33311 Fax:
Phone No 954-343-6554
E-Mail:dominique.brisson@icloud.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail INFO@KINTEXPLUMBING.COM
State or County License CFC1429639
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIED LAW INFORMATION
DESIGNER/ENGINEER:
Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone:_
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:.
Not Applicable
State:
Not Applicable I BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
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 pr erty. A Notice of Commencement must be recorded in the blic records of St.
Lucje County and posted r the jobsite before the first inspectygn. If you intend to obtair financing, consult
wi lender or an attornel✓ before commencing work or recor l g vour Notice of Comm -cement.
Signature of Owner/
as Agent for Owner
STATE OF FLORIDA
COU NTY OF 44
VrSw n to (or affirmed) and subscribed before me of
Ph sical Prese ce or Online Notarization
this day of , 2020 by
Zf n
Name of person making statement.
Personally Known OR Produced Identification J
Type of Identification
Produced t L b il� cv 4�-C s
Afil-lek
(Signature of Notary Public- State of Florida }
Commission Nor'n�'
Signature of Contractor/License
STATE OF FLORID
COUNTY OF 1Gti'rUct�
Sw,grn to (or affirmed) and subscribed before me of
V Ph sical Prese ce or Online Notarization
this day of ��77>�3 �' 2020 by
Name of person making statement.
Personally Known OR -Produced Identification
Type of IcI ifica ' n
Produced , k
I,, '
(Signature of aotary Pub ic- State of
MIRELLA MONTES "3 � ��
6MMISSION #GG336810 Commission No. ;
EXPIRES: MAY 20, 2023
MIRELLA MONTES
Ay COMMISSION #GW
EXPIRES: MAY 20, 20
Bonded through 1st State In:
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED