HomeMy WebLinkAboutPermit Application.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/22/21 Permit Number:
,= 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:Water Heater Changeout
PROPOSED IMPROVEMENT LOCATION:
Address: 5615 Killarney Ave Port St Lucie
Property Tax ID #: 130161303800006 Lot No.
Site Plan Name: Block No.
Project Name:
-
DETAILED DESCRIPTION OF WORK: -
-- ---
Replaced 40 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 %_ Plumbing _ Sprinklers _ Generator Roof
Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2100 Utilities: _ Sewer _ Septic Building Height:
CONS;
NameChristopher Faga _ Name:Dennis Hogan
Address:5615 Killarney Ave Company: Roto Rooter Plumbing services
City: Port St Lucie State: _ Address:1901 Green rd suite H
Zip Code: 35951 Fax: City: Deerfield Beach State: FL
Phone No.954-415-8378 Zip Code: 33064 Fax:
E-Mail. nicholas.mittoo@rrsc.com 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 cfcl428009
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 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.
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 of 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 obtaifinancing, 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 RI-01-2 PIW/
STATE OF FLORIDA
COUNTY OF
Sw rn t or affirmed) and subscribed before me of
Sworn to r affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day ofTC;77��' 2020 by
sical Presence or Online Notarization
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this of 2020 by
Name of person making statement.
Name of person making statement.
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Known OR Produced Identification
Personally Known Z--'-- OR Produced Identification
Type of Identification
Type of Identification
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ev. 5/6/20