HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/09/2021 Permit Number:
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0 IT ° ° ° 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: WATER HEATER REPLACEMENT-LIKE KIND
PROPOSED IMPROVEMENT LOCATION:
Address: 4008 GREENWOOD DR. , FORT PIERCE, FL. 34982
Property Tax I D#: 2421-702-0006-000-6 Lot No.
Site Plan Name: GREENWOOD BILK 1 LOT 5 (0.27 AC) (OR 3824-1717; 1718) Block No.
Project Name: Sec/Town/Range: 21/35S140E
DETAILED DESCRIPTION OF WORK:
REPLACE LIKE KIND 50 GAL ELECTRIC WATER HEATER
New Electrical Meter N/A Second Electrical Meter NIA
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: Sq. Ft. of First Floor:
Cost of Construction: $ 1500.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameJASON MILLER Name:MATT BLACK
Address:4008 GREENWOOD DR. Company:BENJAMIN FRANKLIN PLUMBING
City:
FORT PIERCE , FL. State: Address:6945 NW LTC PARKWAY
Zip Code: 34982 Fax: City: PORT SAINT LUCIE State:FL
772-201-2198 Zip Code: 34986 Fax: 772-871-9069
Phone No.E-Mail:N/A Phone No772_871_9494
Fill in fee simple Title Holder on next page( if different E-Mail PERM ITS@BENFRANKLLINPLUMBER.COM
from the Owner listed above)
State or County License CFC-1 430437
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: x Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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 Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
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Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
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this �day of V L ,2020 by this C day of MC�f(\ � 2020 by
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REVIEWS FRONT ZONING SUPERVISOR PLAINS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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