HomeMy WebLinkAboutbuiilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: % /1 02 Permit Number:
`� 'i L �=�IC I L .��
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential yes
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FORAO gallon electric water heater changeout
Address: 7700 Pine lakes blvd unit#7775 Port St Lucie FL 34954
Property Tax ID #: 3422-596-0007-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric J Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2291 Utilities: _ Sewer _ Septic Building Height:
fr{ . 4 ¢v�jw f R^'
'rV'r$ ." Sbi F' •
Name: Dennis Hogan
Name / /Z
Address:
Company: Roto Rooter
City: /i�i 7L SY L State: �/
Address:1901 Green road
Zip Code:Fax:
City: Deerfield Beach State: FL
Phone No.
Zip Code: 33064 Fax:
E-Mail: OWSC- cs;;z
Phone No954-415-8378
Fill in fee simple Title Holder on next page ( if different
E-Mail NICHOLAS. M ITTOO@RRSC.COM
from the Owner listed above)
State or County License State
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.
C
DESIGNER/ENGINEER: Not Applicable 1L pp
Name:
MORTGAGE COMPANY:
Name:
u
Not Applicable
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
Not Applicable
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 your 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���
COUNTY OF
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 _1L day of /yl �oG �e by
this � day of /yl.�w- 20�9 by
Name of person making statement.
Name of person making statement.
Personally Knowny OR Produced Identification
Personally Known L---- OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Publ f Floi^IC C} OLAS MITTOO
- �;p�,._
f?� f Notary Public . State of Florida
(Signature of Notary Public-
�'jv r� ,, ICHOLAS MITT00
;
Commission No. ` Cqqr�� �1'on # GG 922464
", R •; My Cdfli�. IVores Oct 22. 2023
eQ� tj'!• Notary Public . State of Florida
Commission No. r ion # GG 922464
expires
Bonded through National Notary Assn.
o;; My Oct 22, 2023
Bonded through National Notary Assn.
PLANS
VEGETATION SEA TURTLE
MANGROVE
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
REVIEW
REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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