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HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO WST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: _ Building Permit Application Planning and Development Services Building and Cade Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: Plumbing PROPOSED IMPROVEMENT LOCATION: Address: 9150 N • A18 'PlV405 Legal Description: Ti ara Tow e rs Uln i t -405 N ��r 3 r_-f_4_2� PropertyTax ID#: 1�'2.�J + �0 � � - UC7 - 0dC1 -0 Lot No. 465 Site Plan Name: Block No. Project Name: _ Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: SUPPIY � l nSfali a 40 gallon tall el ec --Yic Nat-er heafer- t R.n CzM CONSTRUCTION INFORMATION: Additional work to e pertormed under l--Mils permit-check all that apply: �HVAC Gas Tank Gas Piping Shutters Windows/Doors L_I Electric Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ Cl 1-3 •©Q Utilities: Sewer Septic Building Height: OWNER/LESSEE; CONTRACTOR: Name Shah P per. holdi n Name: CRAIGMO'BLEY _ Address: 24 to 2 i N& 4 D a v e Company: SOUTHERN PLUMBING, INC City: yt'no B eaC1i - --- Stater Address: 4069 43RD AVENUE Zip Code:32a 1,03 Fax: City: VER©BEACH State: FL Phone No. -1'12 C1Z5 -• 01320 -- _-- zip Code: 32960 Fax: 772-978-9843 E-Mail: Phone No. 772-564-6980 Fill in fee simple Title Holder on next page(if different E-Mail: SOUTHERNPLUMBING@AOL.COM from the Owner listed above) State or County License: RFa067100 if value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPA : MENTAL CONSTiUCTI(3N LIEN 1_,4W INFORMATIi�N: DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X- Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: x Not Applicable Name: Name. Address: Address: City: City, W 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,wails,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 b recorded and posted on the jobsite before the fir nspection. if you intend to obtain financing, cons ith lender or an attorney before commenci rk or recordingour Notice of Commencement JV / 4 f 4 s _5ignat of 0 er/Less /Agent Sign ur of Co tractor/ cerise Holder STATE OF FLORIDA ST E FLORID COUNTY OF INDIAN RIVER COUNTY OF INDIAN RIVER The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this_L_day of H a 20 aby this_L_day of 20 I'l by CLLA (Name of person ckn wledging) (Name of persona nowledging) (Signs u e of Notary P lie-State of F rich ) (Signatur -of Notary Publ State of F rids J Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. - -- - Commission Nc� .; �` 1CYfli- r-e2 �ee5 . %= i i{9RLi� �1Y Revised 07 15 Z 14 a` EXo'IFtES June 1$,ZD1J EXPIRES June 18,2019 pEcndaN0 *Y (40)35�3-U'•53 (4f'7)39fS-9i53 Ffosidal3otaryServwa.coh+ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE CQMPLETE INITIALS