HomeMy WebLinkAboutPermit Application unit #7588All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11?- Permit Number:
` . L lCDE
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
PERMIT APPLICATION FOR:Water Heater Change out
Address: 7700 Pine Lakes Blvd Port St Lucie FL 34954 UNIT #7588
Property Tax ID #: 3422-596-0007-000-6
Site Plan Name:
Project Name:
Removed and replaced 40 gallon Electric water heater
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit —check all that apply:
_Mechanical — Gas Tank _ Gas Piping _ Shutters
Electric !`Plumbing — Sprinklers
Total Sq. Ft of Construction: .
Cost of Construction: $ 1500
NameBR Carroll ST Lucie LLC
Address:7700 Pine Lakes blvd
_ Generator
Sq. Ft. of First Floor:
Residential yes
Lot No.
Block No.
Windows/Doors Pond
Roof Pitch
Utilities: _Sewer _Septic Building Height:
City: Port St Lucie State: _
Zip Code: 34952 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name. -Dennis Hogan
Company: Roto Rooter Plumbing services
Address:1901 Green Road SUITE H
City: Deerfield Beach State: FL
Zip Code: 33064 Fax:
Phone No954-415-8378
E-Mail Nicholas. Mittoo@rrsc.com
State or County License CFC1428009
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.
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State. City: State:
Zip: Phone Zip: Phone:
FEE SAMPLE TITLEHOLDER: _ Nat 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.
1 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.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
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COUNTY OF��
Savor (or affirmed) and subscribed before me of
Sworn t9 (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of , 292fr by
=- Physical Presence or Online Notarization
this ':2� day of 2920-by
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Name of person making statement.
Name of person making stafenient.
Personally Known OR Produced Identification
Personally Known L_. J OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida }
(Signature of Notary Public- State of Florraa )
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Commission Na. F30$-4ed
Commission No. MITT00
Commission GG 922464
Comm:Commission
Notary PublicState of Florida
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DATE
RECEIVED
DATE
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