HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
s
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: 4885 River Oak Ln
Legal Description: RIVER OAK ESTATES WLY 112 OF LOT26 AND ALL LOT 27 (0.35 AC) (OR 3682-2954)
Property Tax ID #: 2430-502-0026-000-6
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No._
Block No.
I DETAILED DESCRIPTION OF WORK: I
Cut 1 cap and reset fixtures I house was flooded during hurricane.
itional work to bffrGtoasTanV
rmed under this permit— cnecK all that appry:
HVAC ❑Gas Piping ILJI Shutters Windows/Doors
❑ Llectric Z Plumbing ❑Sprinklers ❑ Generator Roof
Total Sq_ Ft of Construction: 5 Ft_ of First Floor:
Cost of Construction: $ 1612.00 Utilities: 05ewerF—]Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name George 1 Mary Shimek
Name: Reed Sudderth
Address: 4885 River Oak Lane
Company: CRS Plumbing
City: Fort Pierce state; FL
Zip Code: 34981 Fax:
Phone No_ 772-979-5354
Address: P.O. Box 12755
City: Fort Pierre State: FL
Zip Code: 34979 Fax: 772-460-7774
Phone No. 772-466-7763
E -Mail:
Fill in fee simple Title Folder 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 of Commencement is requirea.
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:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:city:
REVIEW
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
comm€nclne worK or recoraln
_ Signi ure of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF st --
r Nouce OT l,Ommencemeni:_
The forgoing instrument was acknowledged before me
this J J— day of JAN 20 8by
Edward D. Jendan
{Name of person ackn ledging
{signature of Notary Publi ate of Florida }
Personally Known ✓
Type of Identification Pro
vp
Signafbre of
STATE OF FLORIDA
COUNTY OF S,LuaG
Halder
The forgoing instrument was acknowledged before me
this 13 day of JA t-4 20 18 by
Edward D. Jendon
(Name of person ack wledging l
eo4v� J
{Signature of Notary PuubliS ate of Florida }
Personally Known ✓
Mp "
�VDe of Identification C. C> °: EnWecRrn n [er,ne%Ll
My coMMISSIQN #FF124587
Commission Na. •.
EX5M14S May 19, 2018 Commission No.
(407) 398-6153 FlorWalloiarvServicp cnm
Revised 07/15/2014
'= My coo55ISS1 �# #FF124587
a' EXPIFi S y 19, 2018
308.0153
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW REVIEW
DATE
COMPLETE
INITIALS