HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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: 3613 Orange Ave
Legal Description: 8 35 40 E 200 FT OF W 400 FT OF S 185 FT OF N 225 FT OF FOL DESC PROP: E V2 OF N€ 114 OF NW 114 OF SW 114 AND NW 114 OF NE 114 OF SW 114 -
SiJBJECT TO DR ESMT OVER W 10 FT AS IN OR 210-843- LESS AS IN ORD TAKING CA #82-59-05 OR 376-2324- (0.81 AC) (OR 2195-2378)
Property Tax ID #: 2408-312-000"00-8
Site Plan Name:
Project Name:
Setbacks Front Back.
DETAILED DESCRIPTION OF WORK:.
Replace 40 gal elec HWH
Right Side:
lclitional worKto be ertormed under this permit—check a
HVAC Gas Tarok ❑Gas Piping
Electric ❑ Plumbing E]Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 895.00
Left Side:
LJ Shutters
❑ Generator
Sq. Ft. of First Floor: _
Utilities: 0 Sewer O Septic
Lot No.
Block No.
❑ Windows/Doors
Roof
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name VanAntwerp Properties LLC
19
Address: 452 Wenthrop Cir
Company: CRS Plumbing
CC]tat'1TY'
F
Address: P',O. Box 12755
p R 1 D.
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: 3613 Orange Ave
Legal Description: 8 35 40 E 200 FT OF W 400 FT OF S 185 FT OF N 225 FT OF FOL DESC PROP: E V2 OF N€ 114 OF NW 114 OF SW 114 AND NW 114 OF NE 114 OF SW 114 -
SiJBJECT TO DR ESMT OVER W 10 FT AS IN OR 210-843- LESS AS IN ORD TAKING CA #82-59-05 OR 376-2324- (0.81 AC) (OR 2195-2378)
Property Tax ID #: 2408-312-000"00-8
Site Plan Name:
Project Name:
Setbacks Front Back.
DETAILED DESCRIPTION OF WORK:.
Replace 40 gal elec HWH
Right Side:
lclitional worKto be ertormed under this permit—check a
HVAC Gas Tarok ❑Gas Piping
Electric ❑ Plumbing E]Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 895.00
Left Side:
LJ Shutters
❑ Generator
Sq. Ft. of First Floor: _
Utilities: 0 Sewer O Septic
Lot No.
Block No.
❑ Windows/Doors
Roof
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name VanAntwerp Properties LLC
Nairn: Reed Sudderth
Address: 452 Wenthrop Cir
Company: CRS Plumbing
City: Rockledge State: FL
Zip Code: 32955 Fax:
Phone No. 321-863-7631
Address: P',O. Box 12755
City: Fort Pierce State: FL
Zip Code: 34979 Fax: 772-460-7774
Phone No. 772-466-7763
E -Mail:
Fill 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
It 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:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: � Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
City:
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 our Notice of Commencement.
S
_ Sig ure of owner/ Lessee/Agent Sign re of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF st --
The forgoing instrument was acknowledged before me
this __:2_ day of Aur, , 20 (-L-by
Edward O. Jendon
(Name of person acknowledging)
re of Notary Pupli4- State of Florida )
Personally Known Y° OR Produced en ilea ion
Type of Identificati a�`$rarts{u iEDWARD D JENDON
My COMMISSION *FF124587
Commission No. ''f 0, EXPIRE 19, 2()18
396-01M
Revised 07/15/2014
STATE OF FLORIDA
COUNTYOF stLd.
The forgoing instrument was acknowledged before me
this 7 day of AK . 20 j_L_ by
Edward D. Jendon
(Name of person acknowledging)
— 9"�4a Q
( ignature of Notary ",+Public- State of Florida )
Personally o L/ ro uce n
Type of Ide tr'PPc .r Pr RD D .TENDON
y `i My COMMISSION *FF124587
r
Commissio unci � 'f EXPIRES May 105cg0a
(407) 398-0153 FlaridaNctaryServicexurn
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