HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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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 xxx
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 1202 Fleetwood Ln
Legal Description: DRIFTWOOD MANOR -SECTION ONE- LOT3 (0.50 AC) (OR 1308-952; 2252-2060; 2287-2385)
Property Tax ID #: 3404-806-0003-000-4
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Replace existing 20 gallon low boy electric HWH
Lot No.
Block No_
iditional work to bepertormed
❑HVAC 0
under this permit– check all
❑Gas Piping
that apply:
IL�j Shutters
❑ Windows/Doors
Gas Tank
Company: CRS Plumbing
City. Fort Pierce State: FL
Zip Code: 34979 Fax:
Phone No_ 772-323-6049
Address: P.O_ Box 12755
Electric Z Plumbing
❑Sprinklers
❑ Generator
1=l Roof
Total Sq. Ft of Construction: —
Cost of Construction: $ 700.00
S Ft. of First Floor: _
Utilities: Sewer ❑ Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Karen Barron
Name; Reed Sudderth
Address: P -O. Rox 12114
Company: CRS Plumbing
City. Fort Pierce State: FL
Zip Code: 34979 Fax:
Phone No_ 772-323-6049
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: crspiumbing@bellsouth.net
State or County License: CFC1426853
If value of construction is $2500 or more, a RECORDED Notice of Commencement is regwrea.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERJENGINEER: 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:
Zip: Phone:
Zip: Phone:
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 5t. 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.
s
_
SigRgure of Owner) -Lessee/Agent Sign ure o Contractor I se Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF st—
COUNTY OF st-
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this ZZ day of )A -t J , 20 M -by
this 2 Zday of jAt3, 20 { 8 by
Edward D.Jendan
Edward D.Jendon
(Name of person acknowledging)
(Name of person acknowledging)
(' nature of Notary Public- to of Florida)
(5 gnature of Notary Pubf" State of Florida )
Personally Known xxx l i
Personally Known ,••r•••.
r `g•
Type of Identification Prodt EDWeRn n _�F[unr�wi
{ fie..
Type of Identification Ptde'r'= EDWARD D JEPlDON
MyCOMMISSION #FF124587
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Commission No. `. o* EX�f S } May 19, 2018
Commission No. '�` ,, EXPIR26eally 19, 2018
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(40?V 390153 F4oridallotary Service _rnm
(407) 398-4153 Flowallotaryservice.com
Revised 07/15/2014
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