HomeMy WebLinkAboutPERMIT APPLICATION FOR 5407 SUNSET BLVD, FORT PIERCE, FL 34982All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/30/2020 Permit Number:
97. UWE
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U 1 ° Ii c t� w Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FORWATER HEATER REPLACEMENT - LIKE KIND
PROPOSED IMPROVEMENT LOCATION:
Address: 5407 SUNSET BLVD., FORT PIERCE, FL 34982
Property Tax ID #: 3402-609-0242-000-0 Lot No. 24
Site Plan Name: INDIAN RIVER ESTATES -UNIT -08- (MAP 34111 N) (OR 3185-1648) Block No. 58
Project Name:
DETAILED DESCRIPTION OF WORK:
REPLACE 50 GALLON ELECTRIC WATER HEATER IN GARAGE - LIKE KIND
New Electrical Meter N/A Second Electrical MeterN/A
CQNSTRl1CTION INFORMATION:
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: Sq. Ft. of First Floor:
Cost of Construction: $ 1,600.00 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name CALVIN FORD
Name: MATTHEW BLACK
Address: 5407 SUNSET BLVD
Company: BENJAMIN FRANKLIN PLUMBING
City: FORT PIERCE State: _
Address: 6495 NW LTC PARKWAY
City: PORT SAINT LUCIE: State: FL
Zip Code: 34982 Fax. 772-871-9069
Phone No. 772-871-9494
Zip Code: 34986 Fax: 772-871-9069
E-Mail:PERMITS@BENFRANKLINPLUMBER.COM
phone N0772-871-9494
E -Mail PERM ITS@BENFRANKLINPLUMBER.COM
Fill in fee simple Title Holder on next page ( if different
State or County License CFC -1430437
from the Owner listed above)
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 LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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 rule-, 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 recording our Notice of Commencement.
Signat4e of wner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF
Sw rn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this day of Jc {b , 2020 by this ' day of O /alb 2020 by
AIA TT RX -6 1-Hif.. MGL
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification X_ Personally Known OR Produced Identification Y,
Type of Identification Type of Identification 1
Produced yir l rtAhSG Produced :P eVur i'"ir
i5ignat oto Y PU0JI(L1E!,fA&"t,tt)ffYcla 1
- Notary Public • State of Florida2tTl
Commissi commission 0 HH 49112NE
r My dam n. Expires Oct 1,
Bonded through National Notary Assn.
(Signature
N f F Notary Public - State of Norida
Commissi0* Commission I HH 998211
+eRtm 6tpires Oct 1, h14
Bonded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED