HomeMy WebLinkAboutBuilding Permit Application Feb 2817 08:42a CRS Plumbing 772-460-7774 p.2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. �- 01� Permit Number:
RECEIVED FEB 2 8.2017
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential XXX
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 2203 Elizabeth Ave
Legal Description: FLEETWOOD ACRES BLK 3 LOT 12(0.18 AC) 1276-1851)
Property Tax ID#: 2428-604-0048-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
[IXE�TAILEDDESCRIPTION OF WORK:
Remove tub and install new shower.
CONSTRUcTiON INFORMATION:
Additional work to e e orme under t —checkispermit a appy:
]HVAC ❑Gas Piping
_Shutters L1 Windows/Doors
11 Electric Q Plumbing Sprinklers Q Generator Roof
Total Sq.Ft of Construction: Sq.Ft_of First Floor:
Cost of Construction:$ 2380.00 Utilities:U Sewer ElSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Bonny C Arnold Name: Reed Sudderth
Address:2203 Elizabeth Ave Company: CRS Plumbing
City: Fort Pierce State:FL Address: P.D.Box 12755
Zip Code: 34982 Fax: City: Fort Pierce State:FL
Phone No. Zip Code: 34979 Fax: 772460-7774
E-Mail: Phone No. 772-466-7763
Fill in fee simple Title Holder on next page(if different E-Mail: crsplumbing@bellsouth.net
from the Owner listed above) State or County License: CFC1426853
If value of construction is$2500 or more,a RECORDED Notice of commencement is required.
Feb 2817 08:42a CRS Plumbing 772-460-7774 p.3
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:
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,1 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:Yourfailure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded.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.
S
sigr6iture of Owner/Lessee/Agent SigratQre of Contra ctor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOFsrwae COUNTYOF s—
The forgoing instruTem was acknowledged before me The forgoing Instrument was acknowledged before me
this 27 day of CE5 20 Eby this Z77 day of .20 _J? by
Edward D.Jendon Edward D.Jendan
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Publi ate of Florida) (Si ature of Notary Pub c tate of Florida)
Personally Known PtWV4*Mr0fdM6;2N Personally Kno v
Type of Identificati rlF�r d Type of Identifit�to radu �
FJCPIRES May 19,2018 EXPIRES Ma 19 2018
Commission No. �•°' Commission N ` " ry Seal
Florid ervlce.com Idallota ice. m
Revised 07/15/2014
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