HomeMy WebLinkAboutBuilding Permit Application X",
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
t LLCLL -
i:= L. r L L' k' - 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 FOR: Plumbing - water heater change out
PROPOSED IMPROVEMENT LOCATION:
Address: 1001 N 37th ST
Property Tax I D#: 2405-703-0063-000-6 Lot No.9&10
Site Plan Name: Hammonds Block No. 36
Project Name:
DETAILED DESCRIPTION OF WORK:
change out water heater -�_+4-, HU G,J I(,,-� _uA,�Te" —�L"l k_
New Electrical Meter Second Electrical Meter
CONSTRUCTION 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: 1179.50 Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Mary Hammonds Name:Paul Cloutier
Address:1001 N 37th St Company:FPL Home Services
City: Fort Pierce State:_ Address:6001 Village Blvd
Zip Code: 34947 Fax: City: West Palm Beach State:FI
Phone No. Zip Code: 33410 Fax:
E-Mail: Phone N05615298955
Fill in fee simple Title Holder on next page( if different E-Mail Desiree.Pacheco@fpl.com
from the Owner listed above) State or County LicenseCFC1430331
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: _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.
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.
I► A(ale h.- AvL '000cc'1111 Se w
Signature of Ow er/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FL A STATE OF FLORI�
COUNTY OF 2 C COUNTY OF `` ( y►n -'_J%E>�C y1
S h to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
ysical Presence or Online Notarization _Physical Presence or Online Notarization
this day of (( r 202t by this day of n V O f"" f .20A by
Name of persoin making statement. Name of person making statement,
Per alit Known OR Produced Identification�_ Personally own�OR Produced Identification
Te of Id' ntification Type of dent) ication
Pro duced Produ ed
( ignature of Notary Public of Notary Publi s a rNotary Public State of Florida "WNotary Public State of Flonda
eAPacheco De��Ire�e-A Pacheco
Commission Na. mission GG 985385 11ature
mission No. MY6"ssion GG 985385
w�or,Ica Expires 05/061' 24 *�o~s�°RA Expires 05/06/2024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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