HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/28/21 Permit Number:
UrSriaoLUN--IY
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
,PROPOSED IMPROVEMENT LOCATION:
Address: 111 CAMELOT DR.
Property Tax I D #: 1432-801-0044-000-9
Site Plan Name:
Project Name:
Residential X
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
CHANGE OUT 40 GALLON GAS WATER HEATER WITH A NEW TANKLESS WATER HEATER. THE NEW TANKLESS WILL FEED 2 BATHROOMS AND ONLY REQUIRES 120V TO OPERATE.
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
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 500.00
_ Generator
Sq. Ft. of First Floor:
_ Windows/Doors Pond
Roof Pitch
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:: C` ONTRACTOR.
Name VERA MAE HAMILTON Name: CHRIS JOHNSON
Address: 111 CAMELOT DR.
City: FT. PIERCE State:
Zip Code: 34946 Fax:
Phone No. 772-466-4287
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Company: CNJ PLUMBING LLC.
Address: 1701 S. 37TH ST.
City: FT. PIERCE State: FL
Zip Code: 34947 Fax:
Phone No 772-801-3073
E-Mail CHRISJOHNSON@FPUA.COM
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 I MORTGAGE COMPANY: I Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 Horne Owners Association ruler '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 commencine work or recordine vour Nixtice 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 S71, 4t4 e /0
COUNTY OF S' , Lu r
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
,_ X, Physical Presence or Online Notarization
this day of ;� U. , 202Lby
this day of �'�i�,�-�tl , 202) 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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AA
(Si nature of Notary P b4-c-Staftof lori a
(Signature of Nota
MARTHA A KERR
Commission No. '?°.� Notary P ii:al�tate of Florida
.;�;�v P.... MARTHA A KERR
Commission No. _ _�% Notary Public - $�i Florida
rF Commission N GG 311213
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Rev. 5/ b/ LV