HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/29/20 I 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
Residential yes
I
PERMIT APPLICATION FOR: Water heater Changeout
PROPOSED IMPROVEMENT LOCATIONS�-
Address: 2996 Conifer Drive Fort Pierce FL 34951
Property Tax ID #: 132780300030003
Site Plan Name:
Project Name:
Tr10 Nf .Ai F C�
Reemoved and replaced 40 Gallon Electric water heater
New Electrical Meter Second Electrical Meter
Lot No._
Block No.
CONSTRUCTION INFORMATION: - --
Additional work to be performed under this permit— check all that apply:
_Mechanical — Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric h Plumbing _ Sprinklersi _ Generator _ Roof Pitch
Total Sq. Ft of Construction:.
Cost of Construction: $ 1765
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
i ESSEE:
OWNER/LESSEE:
CONTRACTOR: � T
Name Herbert Horne
Name: Dennis Hogan
Address: 2996 Conifer DR
Company: Roto Rooter Plumbing Services
City: Fort Pierce State: _
Zip Code: 34951 Fax:
Phone No.954-415-8378
Address:1901 Green Road Suite H
City: Deerfield Beach State: FL
Zip Code: 33064 Fax:
Phone No954-415-8378
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail nicholas.mittoo@rrsc.com
State or County License State
If value of construction is 2500 or more, a KLLUKUtU Notice or t.0mmencemenL 15 rcyUuCU.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEME'NTAL'CGNSTRUCTION LIEN LAW! INFORMATION
DESIGNER ENGINEER: Not Applicable
/ .� pp
MORTGAGE COMPANY:
Not Applicable
pp
Name:
Name:
Address:
Address:
City: State:
City:
State:
Zip: Phone
Zip: Phone:
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 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.
1aMo�_
2 Al 4n��
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Cont ctor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFBr—ard
COUNTY OFBro-,d
Sworn 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
thi��4 day of Oc-,� 2020 by
this day of b� 2020 by
Dennis Hogan
Dennis Hogan
Name of person making statement.
Name of person making statement.
Personally Known Yes OR Produced Identification
Personally Known yes OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- t ��
(Signature of Notary Public- State of Flo •d
;�v e��,. NICHOI AS MITT00
Commission No. '_°; ~` .: ( I�c - State of Florida
S
NICHOLAS MITT00
;:1Y °� "" •.•
Commission No. �f :. Notary' State of Florida
iss on # GG 922464
orF° MY C ''T =='res Oct 22, 2023
• g Commission GG 922464
:!�o ��?. My Comm. Expires Oct 22, 2023
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