HomeMy WebLinkAboutPermit App WaterHeater CO ShepherdAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
b, LF ,� ,.
L �` l, Lt'; - Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Yes
PERMIT APPLICATION FOR: Water Heater Replacement/Change—Out
PROPOSED IMPROVEMENT LOCATION: Same
Address: 3034 Five Iron DR
Property Tax ID #: 3425-707-0057-000-8 Lot No.24
Site Plan Name: LINKS AT SAVANNA CLUB (PB 40-39) BLK 34 LOT 24 (OR 3996-2721) Block No. 34
Project Name: Water Heater Replacement/Change-Out
DETAILED DESCRIPTION OF WORK:
REPLACEMENT OF VGALLON ELECTRIC WATER HEATER LOCATED IN CLOSET
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION: i
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 1050.00
Windows/Doors Pond
Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Elizabeth B Shepherd JR) Rodney F Higgins JR)
Address:3034 Five Iron DR,
Name: Kliment Stefanov
Company: KINTEX PLUMBING, LLC
City: Port Saint Lucie, FL State:
Zip Code: 34952 Fax:
Phone No.407-497-4900
Address: 2880 W Oakland Park Blvd Suite 200
City: Oakland Park State: FL
Zip Code: 33311 Fax:
Phone No 954-343-6554
E-Mail:
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
IT value oT Construction is 1SUU or more, a KLCUKULU Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPt ENTAL'CONSTRUCTION LIEN
LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
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 perrrrit 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 posteq on the jobsite before the first inspection. If you intend to obtain fi ncing, consult
wit4 lender or an attornpy before commencing work or record& your Notice of Commenc ment.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF BROWARD
COUNTY OF BROwARD
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Yes Physical Presence or Online Notarization
Yes Physical Presence or Online Notarization
this 14 day Of DECEMBER , 2020 by
this 14 day Of DECEMBER 2020 by
KLIMENT STEFANOV
KLIMENT STEFANOV
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification Yes
Personally Known OR Produced Identification Yes
Type of Identification
Prod ce Florida DL Y, MIRELLAMONTES
er' �.� MY COMMISSION #GG336810
a EXPIRES: MAY 20, 2023 1st State Insurance
Type of Identification MIRELLAMONTES
produced Florida oL O�Y'P`°G MY COMMISSION #GG336810
EXPIRES: MAY 20, 2023
% oF0. Bonded through 1st State Insurance
(Signatu a Of Notary Public- St .af.Florida+---
(Signature of Notary Public- State of Florida )
Commission No. GG336810 (Seal)
Commission No. GG336810 (Seal)
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