HomeMy WebLinkAboutGraham_ Permit Applicationpdf All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 06/17/2021 Permit Number:
gr wcm
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 changeout
PROPOSED IMPROVEMENT LOCATION:
Address: 9500 S Ocean Drive, Unit 1904, Jensen Beach , FL 34957
Property Tax ID#: 4502-602-0178-000-9 Lot No.
Site Plan Name: n/a Block No.
Project Name: n/a
DETAILED DESCRIPTION OF WORK:
Like for like Water heater changeout. Installing Rheem-40-Gallon water heater, Electric.
New Electrical Meter Second Electrical Meter
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: $ 800.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Gary Graham Name: Joseph Brownlow
Address:9500 S Ocean Dr, Unit 1904 Company: Premier PLumbing and Air
City: Jensen Beach, FL State:_ Address: 108 NE Dixie Hwy
Zip Code: 34957 Fax: City: Stuart State:FL
Phone No.772-229-9488 Zip Code: 34994 Fax: 772-692-1094
E-Mail: Phone No 772-692-2500
Fill in fee simple Title Holder on next page( if different E-Mail preplbgac@gmail.com
from the Owner listed above) State or County License CFC-1427780
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.
K-
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: Cite: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: —Not Applicable BONDING COMPANY: 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 revi&vv your deecz for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby a,;�ree that i will; in all respects, perform the work
in accordance with the approved plans,the Florida Building Cedes anc 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 YOUR PAYING
TWICE FOR IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER QR AN ATTORNEY BEFORE RECORDING YOUR NOTI F COMMENCEMENT."
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Sign atur o wnerj Lessee/Contractor as Agent for Owner Signnaaty re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA C
COUNTY OF c 4 � CAC( COUNTY OF ��
The for ing instrum nt was acknowledged Wore me The f r g instru nt w acknowledged pefore me
this day of 20Jby this ay of 20'1 by
lru�jy) I�w - use r >� Do')
Name of persoA making statement. Name of person Imaking statement.
Personally Known X OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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(Sign ture o"Pu F igna ure of Notary Public-St e of I T�ciR -; APRILBRUMLEY
#GG 208194 �.commission#GG 2081Commission . ....•r° 47'2022 mmission No. I Apri117,2022
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.