HomeMy WebLinkAbout3105 ANDERSON DR.All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/27/21 Permit Number:
O
p a. 1111(11L° g pp 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
PERMIT APPLICATION FOR: GAS WATER HEATER
PROPOSED41VI ROVEMENT L- CATION:
Address: 3105 ANDERSON DR.
Property Tax ID #: 1432-807-0057-000-
Site Plan Name:
Project Name:
CHANGE OUT 40 GALLON GAS WATER HEATER
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential X
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 _
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 500.00 Utilities: _ Sewer _ Septic
Roof Pitch
Building Height:
OWNER/LESSEE:
CQNTRACTOR:
Name CATHY ELLIS
Name: CHRIS JOHNSON
Address: 3105 ANDERSON DR..
Company: CNJ PLUMBING L.L.C.
City: FT. PIERCE
State:
Address: 1701 S. 37TH ST.
Zip Code: 34946 Fax:
City: FT. PIERCE State: FL
Phone No. 772-461-1305
Zip Code: 34947 Fax:
E-Mail:
Phone No 772-801-3073
Fill in fee simple Title Holder on next page ( if different E-Mail CHRISJOHNSON@FPUA.COM
from the Owner listed above) 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.
Name:_.... , ,,.,_■. .,,r......_...._._
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name;
Address:
City State:
Zip: Phone:
BONDING COMPANY: Not Appiicable
Name:
Address:
C'rty
Zip: Phone:
OWNEIV CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as Indicated.
car* that no work or installation has commenced prior to the issuance of a permit.
St■ Lucre Coun make no representation that Is granting a permit will authorize thegerntit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, 'bylaws an covenants that may restrict or prohibit such
:structure. Please consult mM your Home Owners Assodation and review your eed 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 Lude 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: You 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 jobsrte before the first inspection. If you intend to obtain financing, consult
..ouch lonAmr nr an sttnrnav hafnra rnmrnanrino wnrtc nr rarnrelina vour-NeMea of Commencement.
Signature of Owner / ntractor as Agent for Owner
Signature of Contractor/Ucenseifolder
STATE OF FLORIDA
STATE OF FLORIDA ,
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COUNTY OF11111����11� rq�r11�1.�.1A11��r
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�� U__ _I� 2 y
this ,day of #0- -, , 202J by
Name of person making statemat
Name of person making statement. '
Personally Known OR Produced Identification ' .
Personally Known VX OR Produced Identification
Type of Identification
Type of ldentificatioon
-Produced
Produced
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(Slbatuiv of Notary P gig
(Signatureof No
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Commission No. wry ih Bate at Florida
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