HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABBL``��E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3-,o_I I 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-I578 Commercial _ Residential
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: (9b
Legal Description:
PropertyTax ID#: I -`� 'dU �' ��} - Lot No. .,.,-
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
QETAiLEQ DESCRIPTION OF WORK:
an- !� Q-�-c ajar-9'
CONSTRUCTION INFORMATION:
Additional wor to r orme under t is permit-check a Mapply:
13HVAC n Gas Tank Gas Piping Shutters Windows/Doors
11 Electric 71 Plumbing Sprinklers Ej Generator E]Roof
Total Sq. Ft of Construction: 5 Ft. of First Floor:
Cost of Construction: $ Utilities:O Sewer Septic Building Height:_
OWNER/LESSEE: CONTRACTOR:
Name Name: CRAIG MOBLEY —
Address: u Company: SOUTHERN PLUMBING, INC
City: E plape, State:FL_ Address: 4069 43RD AVENUE
Zip Code: Fax: City: VERO BEACH State:FL
Phone No. -C319 La 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: RF0067100
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAI.'CCJNSTRU l0 IwfEN Ir4V1/ lf�FdR'MATIUN:
Z.
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:
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 rues, bylaws or and covenants that may restrict or prohibit such
structure. Please consuit 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
improve its to your property. A Notice of Commencement must be recorded and posted on the.jobsite
before a first inspection. if you intend to obtain financing, cons with lender or an attorney before
com en in work oc recordingyour Notice of Commencement.
s
t f owner/ essee/Agent Sig at of ontrac ar/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF INDIAN RIVER COUNTY OF INDIAN RIVER
The f rgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this M day of 20 aby this 1 day of ric4us+ 20 ja by
CA&OA f II f'ti.
(Name of persona nowledging) (Name of pers n)acknowledging)
(Signatu of Notary P i State lorida ) (Sin ure of Nota blic-State o orida )
Personally Known OR Produced Identification Personally Known `/ OR Produced Identification
Type of Identification Produced Type of Identification Produced
:,� I'tt.Y AAA`!
Commission No. Commission No. (Seal)
MY CpiVMI SION#FF241665
' EXPIRES june 18,2019 A�,
ac71 asn o+5s F csalloiarVse viee.eon, "= My COMINFISSIU�! FF241865
Revised 07/15/2014 'a= EXPIRES june 16,2019
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