HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/26/2020
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Permit Number:
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 X Residential
PERMIT APPLICATION FORWATER HEATER REPLACEMENT
PROPOSED IMPROVEMENT LOCATION:
Address: 10545 SOUTH OCEAN BLVD., JENSEN BEACH, FL °4957
Property Tax ID #: 4511-500-0005-000-1
Site Plan Name: BEACH CLUB COLONY - SECTION ONE NWLY 49.60 FOOT OF LOT 2
Project Name: SECTION 11 1 TOWN 37S 1 RANGE 41 E - MAP 45111 B
DETAILED DESCRIPTION OF WORK:
REPLACING LIKE KIND WATER HEATER IN BACK OF KITCHEN
New Electrical Meter N/A Second Electrical Meter N/A
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical
Electric
_ Gas Tank
— Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1,800.00
Lot No.2
Block No.
_ Gas Piping _ Shutters _ Windows/Doors Pond
_ Sprinklers _ Generator ` Roof Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameTAMMY L SIMONEAU Name: MATTHEW BLACK
Address: P. O. BOX 6146 Company: BENJAMIN FRANKLIN PLUMBING
City: JENSEN BEACH State: _ Address:6945 NW LTC PARKWAY
Zip Code: 34957 Fax:772`871-9069 City: PORT SAINT LUCIE State: FL
Phone No. 772-871-9494 Zip Code: 34986 Fax: 772-871-9069
E-Mail:PERMITS@BENFRANLINPLUMBER.COM Phone N0772-871-9494
Fill in fee simple Title Holder on next page ( if different E-MailPERMITS@BENFRANKLINPLUMBER.COM
from the Owner listed above) State or County License CFC-1 430437
IT value or construction is 25U0 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.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not App
Name:N1A
Address:
City:
Zip:
Phone
State:
e MORTGAGE COMPANY:
Name: N/A
_ Address:
City:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:NfA
Address:
City:
Zip: Phone:
Zip: Phone:_
BONDING COMPANY:
Name:NIA
Address:
City:
Zip: Phone:_
Not Applicable
State:
_Not Applicable
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 attorney before commencing work or recordine vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA �� ZI
STATE OF FLORIDA r1 '
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COUNTY OFc Zia, _ _
COUNTY OF EST / L
Sworn to for affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
v Physical Pr enc ° r Online Notarization
thi day of , 2020 by
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thi ` ay of 2020 by
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Name of pej'son making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known 1� OR Produced Identification
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Type of Identificatiort //A
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
10
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20