HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3122117 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxxx
PERMIT APPLICATION FOR: plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 5715 Sunset Blvd
Legal Description: INDIAN RIVER ESTATES -UNIT 08- BLK 64 LOTS 10 AND 30 (MAP 34111N) (OR 697-0724; 1290-2650:1493-2699)
Property Tax ID #: 3402-609-0448-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: I
Re -pipe hot & cold water with CPUC piping.
CONSTRUCTION INFORMATION:
Additional work to flasTank
orme un er t is permit—c ec a t appy:
HVAC Gas Piping_ Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers [ Generator 11 Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 5093.00
Sq. Ft. of First Floor:
Utilities: 0 Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Gary H Thomas
Name: Reed Sudderth
Address: 5715 Sunset Blvd
Company: CRS Plumbing
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-577-1593
Address: P.O_ Box 12755
City: Fort Pierce State: FL
Zip Code: 34979 Fax: 772-460-7774
Phone No. 772-466-7763
E -Mail:
Fell in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: crsplumbing@bellsouth_net
State or County License: CFC1426853
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
BONDING COMPANY: Not Applicable
Name:
Address:
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, 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 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 your Notice of Commencement.
Sig a ure of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTYOFSt d -
The forgoing instrument was acknowledged before me
this 22 day of 20 Eby
Edward D. Jendon
(Name of person acknowledging )
(Signature of Notary Publi - ate of Florida )
Personally Known —
Type of Identification I
Commission No"
(407) 398-0153
Revised 07/15/2014
re of Contractor/License Holder
STATE OF FLORIDA
COLINTYOF str
The forgoing instrument was acknowledged before me
this 22- day of MAV- 20 PL by
Edward D. Jendon
(Name of person acknowledging)
(Signature of Notary tu ic- State of Florida j
Personally Known
Y PG '•,
ype of Identification Pro ucet9:-..�..; Pnwnnr, n
Myr COMMISSION #FF12458
EAMNLS May 19, 201 ommission No.
(407) 398-0153
My C0M��{SSIOIV #FF124587
EXP'f#� May f 9, 2071 B
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
BUILDING & CODE REGULATION DIVISION
J _ 2300 VIRGINIA AVENUE
x FORT PIERCE, FL 34982
772-462-1553
FAX 772-462-1576
AUTHORIZATION FORM FOR CREDIT CARD PAYMENT
TO: St Lucie County
RE: 5715 SunSet Blvd
Permit #
Credit Card Users: 1,5016 Surcharge added,per transaction.
Payments must be received in this department by 4:00 PM for transaction to be
processed that day, if not it will be processed the following business day.
XXX VISA
MASTERCARD
Credit Card Number 4802-7800-0061-6887
Expiration Date 02/21 Zip Code 34979
3 digit security code _,--303
Amount $ + 1.5% surcharge
Business Name:
Authorized Signature:
Print Name: Reed Sudderth
Phone: (—=) 466 - 7763
Fax: (-7�) — 460 - 77774
Comments:
SLCPDSD Revised 4/01/2010 EN