HomeMy WebLinkAboutBuilding Permit Application - KELLEY CT All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/18/21 Permit Number:
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Building pp 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: GAS WATER HEATER
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Address: 2408 KELLY CT.
Property Tax ID#: 2421-601-0038-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
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ESCRIPTION O ..WORD.
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CHANGE OUT 40 GALLON GAS WATER HEATER WITH ANEW TANKLESS WATER HEATER.THE NEW TANKLESS WILL FEED 2 BATHROOMS AND ONLY REQUIRES 110V TO OPERATE.
New Electrical Meter Second Electrical Meter
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STRUCTION .I N F. RM k, F ,1 ,
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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: $ 500.00 Utilities: —Sewer _Septic Building Height:
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WNER LESSEE. CONTRACT
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Name SUSAN E. GREEN Name:CHRIS JOHNSON
Address:2408 KELEY CT. Company:CNJ PLUMBING LLC.
City: FT. PIERCE State: Address: 1701 S. 37TH ST.
Zip Code: 3498? Fax: City: FT. PIERCE State:FL
Phone No.772-475-0484 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.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
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: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 Horne 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 attornev before commencing work or recording our N 'ce of Commencement.
Signature of Owner a e/ ontractor as Agent for Owner Signature of Contractor/License older
STATE OF FLORIDA STATE OF FLORIDA '
COUNTY OF _S 4b e—/C COUNTY OF
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization _. o.Physical Presence or Online Notarization
��
this, day of _ ,202Lby this�day of h f1M .2021 by
Name of person making statement. Name of person making statement.
Personally Known w��OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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(Signature of Notary P b'c- t of lori a (Signature of Nota
•�.,,,•. .,, :a' Y p�'', MARTHA A KERR
,��►v a MARTHA A KERR
Commission No. '?�% Notary Pt iealitate oflRi
Commission No. -_-
-Commission Notary Public-$�i�Florfda
1 Commission N GG 31 =.�, ommission 1j GG 311213
My Comm.Expires Mar ,Q :.• My Comm.Expires Mar 22,2023
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REVIEWS FRONT ZONING SUR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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