HomeMy WebLinkAboutDOC012021All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/11/21 Permit Number:
ST. LUCIE
C(JU;N-T�Y
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential X
PERMIT APPLICATION FOR: GAS WATER HEATER
,. '"�: a t S
l
PROPOSED IIVIPROVEMENT LOrCATION. :t A
Address: 2610 BENNETT DR.
Property Tax ID #: 1432-807-0051-000-9
Site Plan Name:
Project Name:
CHANGE OUT 40 GALLON GAS WATER HEATER.
New Electrical Meter Second Electrical Meter
Lot No.
Block No.
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 _
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 500.00 Utilities: —Sewer _ Septic
Roof Pitch
Building Height:
• T
.OWN ER/LESSEE.
' t ' ✓ {f i ..• is Yam' .0 ha5f .T L 2 bi S� E .
CONTRACTOR. x
Name WILLIE HAMMOND JR.
Name: CHRIS JOHNSON
Address: 2610 BENNETT DR.
Company: CNJ PLUMBING LLC.
City: FT. PIERCE State:
Address: 1701 S. 37TH ST.
Zip Code: 34946 Fax:
City: FT. PIERCE State: FL
Phone No. 772-360-8609
Zip Code: 34947 Fax:
E-Mail:
Phone No 772-801-3073
Fill in fee simple Title Holder on next page (if different
E-Mail CHRISJOHNSON@FPUA.COM
from the Owner listed above)
State or County License 30950
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.
�cI�PPL�iMEN�" �ONS�'RU1.iiY�ON :L�.�N: LAU1l �I�iFOR'Mi"iTIO.N., s�
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 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 N_gtice of Commencement.
Rev.
Signature of Owner a ee/ ontractor as Agent for Owner
Signature of Contractor/License older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S�0C
COUNTY OF S� L(,� C
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
this � day of 202by
this � .day of �--- , 202� by
Name of person making statement.
Name of person making statement.
Personally Known � OR Produced Identification
Personally Known ;� OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Si nature of Notary P b 'c- t of lorida
(Signature of Notar
,��a�'!poe••.. MARINAAKERR
Commission No. Notary Pt(t$1e�al�tate of Florida
Y'PU'••.• MARTHAAKERR
Commission No. � _ % ��'• �; Notary Public - $tyFlorida
-Commission
• Commission N GG 311213
'•'�`',n� ��My Cnttrm, Expires Mar 22, 2023
•:•,�o o�P;= M N GG 311213