HomeMy WebLinkAboutBUILDING PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/8/21 Permit Number:
S5-ro LEE
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: WATER HEATER REPLACEMENT
PROPOSED IMPROVEMENT LOCATION:
Address: 10980 S OCEAN DR 512
Property Tax ID #: 4512-702-0017-000-1
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
30GAL ELECTRIC WATER HEATER REPLACEMENT
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
_ Electric -�- Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: _
Cost of Construction: $ $2059.00
Sq. Ft. of First Floor:
Lot No.
Block No.
_ Windows/Doors _ Pond
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Brett Long
Name: Richard Bassoff
Address: 230 Lakeshire RD
Company : ADMIRAL PLUMBING SERVICES, A SERVICE EXPERTS COMPANY
City: Battle Creek , MI State: _
Zip Code: 49015 Fax:
Phone No. (269) 986-0101
Address: 2895 JUPITER PARK DR #700
City: JUPTIER State: FL
Zip Code: 33458 Fax:
Phone No 561-746-1180
E-Mail: brett2323@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail 208PERMITTING@SERVICEEXPERTS.COM
State or County License CFC1425116
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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: NotApplicable
Name:
BONDING COMPANY: _Not Applicable
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 attornev before commencing work or recordine vour Notice of Commencement.
l L ///
Signature of Owner L e/Contractor as Agent for Owner
! /'///
Signature of Con r icense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF PALM BEACH
COUNTY OF PALM BEACH
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
x Physical Presence or Online Notarization
_
this 8 day of FEB 2020 by
_
this 8 day of FEB 2020 by
RICHARD BASSOFF
RICHARD BASSOFF
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Pr7ced
Produced
( ture of No a Publi
Ig ature of Nota Pub'
,. �.0 Notary Public State of Florida
mission No. JagpuBline Georgescu
Notary Public State of Florida
mission No. �° JacgJ LgglGeorgescu
MyrfMfission GG 233150
Z3C) of M1� Expires 06/28/2022
In f
Ex Co miss /2 22 233150
Ada Expires 08/2e/2022
C.J31
pd�
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/6/20
4
Adkdral
F"r PLUMBING SERVICES
A Service Experts Company
Billing Address
Brett Long
10980 S Ocean Drive #512
Jensen Beach, FL 34957 USA
Admiral Plumbing Services
A Service Experts Company
2895 Jupiter Park DR #700
Jupiter, FL 33458
561-746-1180
License: CFC 1426115
Invoice 38035867
Invoice Date 11/25/2020
Terms COD
Completed Date 11/25/2020
Customer PO
Job Address
Brett Long
10980 South Ocean Drive
#APT 512
Jensen Beach, FL 34957 USA
Description of Work
Furnished and installed 30 gallon lowboy water heater with two ball valves, three-quarter inch flexes, and permit. Had to
cut out condensate for AC system coupling that back together
Ran TMP to the pan installed. Flood stop
3500 W Rheem 30 gallon lowboy that was installed.
Permit is required. Customer is responsible for any additional requirements from building department.
Task #
Description
Quantity Your Price Your Total
T61200
LOWBOY 30 GALLON ELECTRIC WATER HEATER
1.00
$944.00
$944.00
PermitWH
WaterHeater- Permit
1.00
$225.00
$225.00
*Required by Building Department
ELCWHIP-
ADMIRAL PLUS PACKAGE COVERS ALL CODE REQUIREMENTS AND INCLUDES
1.00
$595.00
$595.00
PLUS
THE ITEMS RECOMMENDED TO REPLACE WHEN INSTALLING A NEW TANK AT A
DISCOUNTED, PACKAGE PRICE
Professional installation of New Electric Water Heater
*New Drain Pan
*Copper Line Retrofit
*Water Heater Stand if necessary
*New 3/4" Ball Valve Shut Off
*Install to Code
*Haul off and Dispose / Recycle old Water Heater
*New Expansion Tank
T99923
Furnish and Install Water Heater Flood Stop
1.00
$395.00
$395.00
Plug in or Battery
*Batteries must be replaced yearly
Discount
Discount- Postcard
1.00
$-100.00
$-100.00
Paid On
Type Memo
Amount
11/25/2020
Check
$2,059.00
Sub -Total
$2,059.00
Tax
$0.00
Total Due
$2,059.00
Payment
$2,059.00
Balance Due $0.00
I hereby agree to have Admiral Plumbing Services A Service Experts Company complete the work described for the proposed price
regardless of the time it takes to complete the work.
11/25/2020
1 hereby acknowledge the satisfactory completion of the above described work.