HomeMy WebLinkAboutBuilding Permit Application � - -VW4 W
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 07/26/2021 Permit Number:
si, Luycm
Y Iz c I, ° 15 Building pp Permit Application
Plonning 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:WATER HEATER REPLACEMENT - LIKE KIND i
PROPOSED IMPROVEMENT LOCATION:
Address: 7400 Laurels PLPort St Lucie, FL 34986
Property Tax ID#: 3322-501-0021-000-9 Lot No.18
Site Plan Name: PARCEL 15A AT THE RESERVE LOT 18(OR 3619-2314) Block No,
Project Name: WATER HEATER REPLACEMENT- LIKE KIND
DETAILED DESCRIPTION OF WORK:
WATER HEATER REPLACEMENT UNDER MANUFACTURES WARRANTY- LIKE: KIND
5C)0,00C�
New Electrical Meter NIA Second Electrical Meter N/A
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: $ 634-00 Utilities: —Sewer —Septic Building Height:
OWNERAESSEE: CONTRACTOR:
NameDONNA BUSCEMA Name:MATT BLACK
Address:7400 LAURELS PLACE Company:BENJAMIN FRANKLIN PLUMBING f
City: PORT ST. LUCIE, FL State:_ Address:6945 NW LTC PARKWAY
Zip Code: 34986 Fax:NIA City: PORT ST. LUCIE State:FL
Phone No.772-871-9494 Zip Code: 34986 Fax: 772-871-9069
E-Mail:PERMITS@BENFRANKLINPLUMBER.COM Phone No 772-871-9494
Fill in fee simple Title Holder on next page(if different E-Mail PERMITS@BENFRANKLINPLUMBER.COM
from the Owner listed above) State or County License CFC# 1430437
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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.
5t. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
structure. Please consult w with Home owners Association
and revie bylaws r deed for any restrictions that which may apply.obit such
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 o meneement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COU NTY OF �t 4 X. COUNTY OF
swop to(or affirmed)and subscribed before me of swor o for affirmed)and subscribed before me of
✓ Physical Presence or online Notarization Physical Presence or Online Notarization
this day of 2020 by this day of_ , 2020 by
N u f;1I I P � a('
Name of person making statement. Name of person making statement.
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Personally Known � OR Produced Identification Personally Knowntio� OR Produced Identification
Type of Identification Type of identification
Produced
Produced
(Sign a ) (Sigti.... Idda
tY►' JULIE
JULIE JANE MCCAULEY Notary Public.sta'°^`=torica (Seal)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
PATE
COMPLETED
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