HomeMy WebLinkAboutBUILDING PERMIT APPLICATION04/26/2019 12:03 FAX
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED - a
Date: 412kig Permit Number:
SCANNED
BY IRECEIVED
St. Lucie County
Building Permit Applicati n26 2019
Planning and Development Services Stunty, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierre FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PeRMITTvaE:WATER HEATER REPLACEMENT
Address: 4201 S INDIAN RIVER DRIVE FORT PIERCE FL 34982
Property Tax ID #: 2435-113-0003-00D-0 Lot No.
Site Plan Name: 311540S 100 Fr OF N 1040 Fr OF E 12 OF NE 114WITN RIPRTS-LESS RD AND FEC RR- (10)(OR 138U2n Block No.
Project Name: BURRITT WATER HEATER REPLACEMENT
REPLACE 120 GAL SOLAR WATER HEATER OUTSIDE UTLITY ROOM
TANK CNL`l
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _Shutters —Windows/Doors
_ Electric _ Plumbing —Sprinklers _ Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 3100 Utilities: —Sewer _Septic Building Height:
Name Chase Burritt Name: ROBERT LUDLUM
Address:4201 S INDIAN RIVER DRIVE Company:BENJAMIN FRANKLIN PLUMBING
City: FORT PIERCE State: _ Address:1631 SW S MACEDO BLVD
Zip Cade: 34982 Fax: City: PORT SAINT LUCIE State: FL
Phone No.772-871-9494 Zip Code: 34984 Fax: 772-871-9069
E-Mail:PERMITS@BENFRANKLINPLUMBER.COM PhoneN0772-871-9494
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 CFC1426801
If value of construction is$2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement Is required.
04/26/2019 12:03 FAX
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DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State: _
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Address:
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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MU BE RECORDED AND
POSTED ON THE JOB S E THE FIRST INSPECTION. IF YOU INTEND TO OBT NCING, CONSULT
WITH YOUWLENDERA II Adf ANORNEY BEFORE RECORDING YOURAMCE OF COM "
Si&qratfrowniTrXe-si-ee/contractor as Agent for Owner
of Co ract censeHolder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF sTLuc E
COUNTY OF stwaE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this ZS" day of AD"-, % . 20A by
this? day of 47e J2 .204 by
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Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Knowny OR Produced Identification
Type of Identification
Type of Identification
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Produced
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