HomeMy WebLinkAboutPermit - 5711 Palmetto Dr - SignedALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxx
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 5711 Palmetto Dr
Legal Description: INDIAN RIVER ESTATES -UNIT 06-BLK 10 LOTS 34 AND 35 (MAP 34/11N)(OR 4079-1630)
Property Tax ID #: 3402-607-0031-000-2
Site Plan Name:
Project Name:
Setbacks Front Back:
Run 80' of 1" pipe to new water meter.
Right Side: Left Side:
Lot No._
Block No.
Additional work to be
nertormed under this permit —check all na apply:
[1HVAC LJ Gas Tank ❑Gas Piping Shutters ❑ Windows/Doors
11 Electric LTJ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 650.00 Utilities:Sewer 0 Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name F&D Investment Group LLC
Name: Reed Sudderth
Address: 5711 Palmetto Dr
Company: CRS Plumbing
City. Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No_
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 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 OT 4ommencement is requires.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: i Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 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.
—sign ture of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF St Lucie
The forgoing instrument was acknowledged before me
this _L day of JA/J 20Eby
Edward D.Jendun
(Name of person acknowledging }
G'�ctJirul���.
(Signature of Notary Public(St to of Florida)
Personally Kno
Type of Identifi &DN F L D_.I
Commission N
996-6153
Revised 07/15/2014
My COMMISSION #LFF124587
EXPJ-RES M �9, 2018
ctor/License
STATE OF FLORIDA
COUNTY OF stL d.
The forgoing instrument was acknowledged before me
this day of J A jJ 20 14by
Edward D.Jendon
(Name of person acknowledging)
(Signature of Notary Publi - st to of Florida ]
Personally knowUK Produceden i ica ion
Type of Identific is #i egDWARD D JENDON
*' MY COMMISSION #FF124587
Commission No. EXPIRES f489aio, 2018
14074 =1 FfgridANn1Rrv9PrviPe-Pnm
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