HomeMy WebLinkAbout2906 ANDERSON DR.All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/7/21 Permit Number:
ST. l.uc� E
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: GAS WATER HEATER
PROPOSED IIVIPROVEIVIENT LOCATION:
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Address: 2906 ANDERSON DR.
Property Tax ID #: 1432-807-0001-000-4
Site Plan Name:
Project Name:
CHANGE OUT 40 GALLON GAS WATER HEATER
New Electrical Meter Second Electrical Meter
CONSTRU'CTI�d INFORMATION 3
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: $ 500.00
Name ALEXANDER MOYE
Address: 2906 ANDERSON DR..
City: FT. PIERCE State:
Zip Code: 34946 Fax:
Phone No. 772-591-8894
E-Mail:
_ Generator
Sq. Ft. of First Floor:
Lot No.
Block No.
_ Windows/Doors Pond
Roof Pitch
Utilities: —Sewer _ Septic Building Height:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: CHRIS JOHNSON
Company: CNJ PLUMBING LLC.
Address: 1701 S. 37TH ST.
City: FT. PIERCE State: FL
Zip Code: 34947 Fax:
Phone No 772-801-3073
E-Mail CHRISJOHNSON@FPUA.COM
State or County License 30950
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.
'VENOMS
Not Applicable MORTGAGE COMPANY: Not Applicable
DESIGNER/ENGINEER:
Name:
Name:---
Address:
Address:
City
State:
City: State: _.�.._.
Zip: Phone �
�
Phone:
Zip: •
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
i Address:
City
City: --
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application 1s hereby made to obtain a permit to do the work ano rnsonazron as indicated.
certify that no work or installation has commenced prior to the issuance of a permit.
St Lucre Caunmakes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Horne Owners Assod 'on 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
...;•a ta..aey- ow ftn stinmakir hofnrz enmmanrina wnrk nr rpenri ing vnur NeMea of Commencement.
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Signatureof Owner / ntractor as Agent for Owner
Signature of Contractor/Ucenseifaider
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF..5 : /_,, o l e - -
COUNTY OF S LGRS.1.,1�'-
Sworn to (or affirmed) and subscribed before me of
Sworn -to (or affirmed) and subscribed before me of
_0 Physical Presence or. Online Notarization,
Physical Presence or ' Online Notarization
,
this day of , �} _ . 202.by
this �; day of = f'�-.�! , 202 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced identification
_��
Type of Identification
Type of Identification
-Produced
Produced
.44 -
(Slinatuie of Notary P 'c of Lori a I
(Signature of Note
.�► MAR' HAA KERR
` p`rgc" MA90AA KERR
Notary Public-
Commission No. -� NOtary P&alltate of Florida
Commission No. �= loft
CWMI IM q GG 311213
`+ • MY Cantu. ExptM Mar 2212023
.� �# 61ra"on I GG 311213
' ININI M: Comm. Expires Mar 22, 2023
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