HomeMy WebLinkAbout8117 MULLIGAN CIR. PSL, FL. 34986 WATER HEATER PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address:
J
Property Tax ID #: 025 -I - S
Site Plan Name
Project Name:
DETAILED DESCRIPTION OF WORK:
- Ll, Yp L i
New Electrical Meter N H Second Electrical Meter TV IQ (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
Lot No. QQ
_Mechanical
— Gas Tank
_ Gas Piping
Shutters
_ Windows/Doors
Pond
Electric
Plumbing
Sprinklers
_ Generator
_ Roof
Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ _�At5o cc)
Sq. Ft. of First Floor:
Utilities
Sewer _ Septic Building Height:
I OWNER/LESSEE: I CONTRACTOR:
Name y� C
Addre s: fLka fyIL, i v\ C `
City: A. Zk. State, .r
Zip Code: _3 lGye Fax- _rYax- 1-C 4
Phone No.-712 -�H 1-QILA l E-
Mail:CiAni 4 a c(ti1'��iGrl�lir�{J�U.I+�IfLcv►
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: ivlek-k-V 171Ca.CK.
Company: n F i, _ '
Address: i-1 % J
City: _2 C C-A. LSxCIQ State: FL
Zip Cade: 15XP M Fax: T-4 i-gC'rGF'l
Phone No I-C}1-l0(t{
E-Mailtn.►�YhCtc,��kl�nOirx►tin�el.c
State or County LicenseC-ECta
if value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is S7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION;
DESIGNER/ENGINEER: �L_ Not Applica
Name: _
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name;
Address:
City:
Zip: Phone: _
State:
Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: _ State:
Zip: Phone:
BONDING COMPANY:
Name;
Address:
Citv:
Zip: Phone:
Not Applicable
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
which conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 attorney before commencing work or recording your Notice of Commencement.
Signatur of Contractor - or - Owner Builder as applicable
STATE OF FLORIDA,_
COUNTY OF N) o< u-ctx'
Sworn to (or affirm d) and subscribed before me of _✓ Physical Presence or
Online Notarization
this — day of 2aZZ by
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Name of person maki'hg statement.
OR Produced Identification
Personally Known
Type of Identification Produced dD r s- It LLn s-p-
I
(Si nature of i
I
JULIE JANE MCCAULEY
Notary Pu $ej to of Refiea
Commission N - om ,scion =HN 49824
My Comm. Expires Oct t, 202.s
lorded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION
COUNTER REVIEW REVIEW REVIEW REVIEW
SEA TURTLE MANGROVE
REVIEW REVIEW
DATE
RECEIVED_
__.._..__...
DATE
I COMPLETED