HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1211512021 Permit Number:
Building Permit Application
Plonning ond Development Services
Building ond Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL j4982
Phone: (772) 462-L553 Fax: (772\ 462-1578
Commercial Residential x
CBDG Funding
PERM lT APPLICATION FOR: *rter Heater
PROPOSED IM PROVEMENT LOCATION :
Address:10750 HEIL ROAD
Property Tax lD #:
Site Plan Name:
2321-501-0022-000-0 Lot No.
Block No.
Project Name: LUSTER WATER HEATER
DETAILED DESCRIPTION OF WORK:
change out of like for like propane water heater
New Electrical Meter Second Electrical Meter.(Affidavit required)
CONSTRUCTION I N FO RMATION :
Additional work to be performed under this permit - check all that apply:
_Mechanical X Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Generator _ Roof _ Pitch_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:Sq. Ft. of First Floor:
Cost of Construction: $2445.30 Utilities: _ Sewer _ Septic Building Height:
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
lf value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
OWNER/LESSEE:CONTRACTOR:
Name JOHNNIE LUSTER
Address: 10750 HEIL ROAD
City: FORT PIERCE state:FL
Zip Code: 34945 Fax:
Phone No. 7728785123 e-
Mail: nioh ns@m irandacom pan ies. com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: Don Miranda
Company:Miranda Plumbing & AC
Address: 750 NW Enterprise Dr Suite 100
City: PSL State: FL
Zip Code: 34986 Fax:
phone No 7728785123
E-Mail njohns@mirandacompanies.com
State orCounty License CFC1427227
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City:
Lip:.
State:
Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
zip:Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip:
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 Lt/cieCountymakesnorepresentationthatisgrantingapermitwill authorizethepermitholdertobuildthesubiectstructure
which is in conflict with.any applicable Home Owiers AsSociation rules, bvlaws or and covenants that mav restrict dr prohibit suchstructure. Please consult with riour Home Owners Association and review'your deed for any restrittidniuitriih mav appV, - -
ln 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 5t, 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
..WARIIIING TO OWNER: YOUR FAITURE TO RECORD A NOTICE OF COMMENCEiIEIIIT MAY RESULT IN YOUR PAYIIUG
TWICE FON IMPROVEIIIEI\ITS TO YOUR PROPERTY. A IUOTICE OF CO}IMENCEIIIENT MUST BE RECORDED AND
POSTED OIU THE JOB SITE BEFORE THE FTRST |NSPECTION. IF yOU IUTEilD TO OBTAII FINANCING, COilSULT
WITH YOURIEUUER OR AN ATTORNEY BEFORE RECORDING@ENCEIIIENT.,,
Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY Qf stt-ucie
The foreoing instru--ent was acknowledged before me
Name of person making statement.
Personally Known *, OR Produced ldentification
(Signature of Notary Public-
Commission No.
Type of ldentification
STATE OF FLORIDA
COUNTY Qpstt-ucie
The forqoing instrumo.t ,^/?s acknowledged before me
Don Mirsnda
Name of person making statement.
Personally Known ux OR Produced ldentification
Type of ldentification
Produced
(Signature of Notary Public-
mission No.
Bonded thru Aaron
Feb, 0,
SUPERVISOR
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETED
Address:
City:Zip:_