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DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: DSNot Applicable
Name:
Address:
Address:
City:
Zip:
State:
Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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
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STATE OF FLORIDA
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Sworn to (or affirmed) and subscribed before me of
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Personally Known L*-'-- OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
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Produced
(Signature
��yir'P�s;, NICHOLAS MI 0
(Signature of Notary Pu tnJ&nLElgridaJ
Notary Public • State of Florida
Commission ��gCommission # GG 92�S8a1)
NICHOLAS MITT00
Commission No. Notary f��ljtate of Florida
y'�` ova ati'T° My Comm. Expires Oct 22, 2023
tp g Commission GG 922464
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Bonded through National Notary Assn.
My Comm. Expires Oct 22, 2023
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
ded through National
Nuoly Ann.
MANGROVE
SEA TURTLE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/22/21 Permit Number:
W 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
PROPOSED IMPROVEMENT LOCATION:Garage
Address: 372 Tranquilla Ave Port St Lucie FL 34983
Property Tax ID #: 3419-530-0132-000-7
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replaced 40 Gallon Electric water heater
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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 Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ _ Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameJason Lindley
Name: Dennis Hogan
Address: 372 SE Tranquilla Ave
Company: Roto Rooter Plumbing services _
City: Port st Lucie State: _
Zip Code: 34983 Fax:
Phone No.954-415-8378
Address:1901 Green road Suite H
City: Deerfield Beach State:
Zip Code: 33064 Fax:
Phone No954-415-8378
E-Mail: nicholas.mittoo@rrsc.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail nicholas.mittoo@rrsc.com
State or County LicenseCFC1428009
it vaiue or consiruciion is ZSuu 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.