HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/23/21 Permit Number:
. Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FORMater Heater Installation
PROPOSED IMPROVEMENT LOCATION:
Address: 771 Sandburg Lane
Property Tax ID #: 3415-706-0038-000-5
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Install Hot Water Heater
0 C��rca✓
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 Y, Plumbing _ Sprinklers _ Generator
Lot No.
Block No.
Windows/Doors _ Pond
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1,7-00 Utilities: —Sewer Septic
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Milton Hahn
Name:Wade Case
Address:771 Sandburg Ln
Company: Lindquist Plumbing & Supply Company .,INC
City: PSL State:r_C
Zip Code: 34952 Fax:
Phone No. 772-468-2306
Address:3185 Sneed Road
City: Fort Pierce State: FI
Zip Code: 34945 Fax: 772-461-1999
Phone No772'461-1969
E-Mail:n/a
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Lindquistplumbingcompany@gmail.com
State or County License26901
If value of construction is 2500 or more, a RECORDED Notice of Commencement is regwrea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 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
STATE OF FLOO�IDA
COUNTYOF S+ Laaetc Countki
COUNTY OF � I ta_LL P.Nu,Iq
Savory to (or affirmed) and subscribed before me of
✓ toPresence or _ Online Notarization
this n day of 1�_, 2020 by
Swoyn to (or affirmed) and subscribed before me of
✓ Physical Presence or Online Notarization
this 23 day of J�w1= 2022,by
Name of person making statement.
Name of person making statement.
Personally Known ✓ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of - }M.'"•
(Signature of Notar '
INK Notary Public State of Florida
Commission MirhelleTr aHH
M Expires 03/07/2i H
4LNotary Public Stara of Florida
Commission No. r; MichelleTrIftal)
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Alard� Expires D3107QO26
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