HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION! TO BE ACCEPTED
Date:
F L O R F D A
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 Xx
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 3711 Avenue Q
Legal Description: SUNLAND GARDENS BLK 15 LOT 6 -LESS N 10 FT- (0.17 AC) (OR 2401-1925:2907-1655)
Property Tax ID #: 2405-601-0274-000-5
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
[DETAILED DESCRIPTION OF WORK:
Convert tub to shower.
Lot No.
Block No.
Aaairionai work ro ue perTormea unaer finis permr< — cnecK ani n i appry:
HVAC _ Gas Tank E]Gas Piping _ Shutters Windows/Doors
11 Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2250.00 Utilities: 0 Sewer []Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Andrea Dampier
Name: Reed Sudderth
Company: CRS Plumbing
Address: 2000 N 43rd St
City: Fort Pierce State: FL
Zip Code: 34947 Fax:
Phone No. 772-713-4879
Address: P -O- Box 12755
City: Fort Pierce State: FL
Zip Code: 34979 Fax: 772-460-7774
Phone No. 772466-7763
E -Mail:
Fill in fee simple Title Halder on next page ( if different
from the Owner listed above)
E -Mail: crsplumbing@belisouth.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:
Andress:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counter 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 recoraing your Notice or commencement.
4�"�y
s
_ Si ature of Owner/ Lessee/Agent Sign re of ontractar License Holder
STATE OF FLORIDA
COUNTY OF St wce
The forgoing instrument was acknowledged before me
this I day of __ J(fN , 20 Eby
Edward D.Jendon
(Name
of person acknowledging )
r _
]�MA�
(Signature of Notary Pu t1state of Florida)
Personally Knovgn f 118 Prr3dUrgdJAJVZ
Type of Identifi ti-tw }, wt-�7n n .
l� MY COMMISSION *FF124587
Commission No. :� �` 4Seal
IRES 9, 2018
398-4153
Revised 07/15/2014
STATE OF FLORIDA
COUNTY OF stw-g
The forgoing instrument was acknowledged before me
this __L day of J(JAI , 20 17 by
Edward D. Jendon
(Name of person acknowledging)
_9"IJOQ66,
(Si nature of Notary Pu li State of Florida )
Personally n
Type of Iden PrC
MY COMMISSION #FF124587
Commissio .)=XI2!R=C May 10 a
1447)598-n 153 FloridaNutaryServtce.com
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