HomeMy WebLinkAboutBuilding Corrected ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
8 o C I CllL
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 FOR: Electric Water Heater Change Out
PROPOSED IMPROVEMENT LOCATION:
Address: 7700 Pine Lakes bled Port st Lucie FL 34954 UNIT
Property Tax ID #: 3422-596-0007-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILEO DES RIP "IONI OF WORK
Replaced66'Gallon Electric Water heater
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 k Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 0i2C>&0 Utilities: —Sewer _Septic Building Height:
Name BR Carroll ST Lucie LLC Name:Dennis Hogan
Address:7700 Pine lakes blvd Company: Roto Rooter Plumbing services
City: Port St Lucie State: — Address:1901 Green road suite H
Zip Code: 34952 Fax: City: Deerfield Beach State: FL
Phone No.954-415-8378 Zip Code: 33064 Fax:
E-Mail: Phone No954-415-8378
Fill in fee simple Title Holder on next page ( if different E-Mail Nicholas. mittoo@rrsc.com
from the Owner listed above) State or County License CFC1428009
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.
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DESIGNER/ENGINEER: Not Applicable
Name:
d
MORTGAGE COMPANY:
Name:
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s a•
Not Applicable
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
— Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zi p: 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 our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF &-a-J,9...- al
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
ysical Presence or Online Notarization
this of 2020 by
Physical Presence or Online Notarization
this day
y 1� '
of , 2020 by
Name of person making statement.
Name of person making statement.
Personally Knowny/OR Produced Identification
Personally Known ---'OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notar
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(Signature of Notary Pu on i]IOLAS MITT00
Commission NO.
��` Nota Publ� $�Florida
•'t ry
NICHOLAS MIT:c92
1�Y PCB;•. public - State of Florida
g: Notary
Commis ion NO. # GG 922464
CO5s Oct22,2023
a; CommissbnGG464e`
My Comm. Expires O2, 2023
0° My Co m• Assn.
Bonded through National Notary
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