HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /-12 %a _ Permit Number: _—
5 J _
o I -
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL .4982
Phone; (772) 462-1553 Fax; (772) 462-1578 Commercial zResidential
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
4 *
Property Tax ID M, 11 2' i� Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back; Right Side
Left Side:
Block No.
DETAILED DESCRIPTION OF WORK:
t l I(1 Oua q0�f-YfC� !`
CONSTRUCTION INFORMATION:
Additional work toe performed under t is permit – check all
tatj appy:
1—:1 HVAC 1:1Gas Tank 0GasPiping I ]Shutters Windows/Doors
Flectric 71 Plumbing Sprinklers 12 Generator 0 Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ �� l Utilities:Sewer Septic Building Height: _
OWNER/LESSEE:
CONTRACTOR:
Name 1
Name: CRAIG MOBLEY -- -
Address: I IN
Company: SOUTHERN PLUMBING, INC
Address: 4069 43RD AVENUE
City: K ( ty i 1Z IQ.Q.k- State: kT
City: VERO BEACH State: FL
Zip Code: + Q5 � Fax:
Phone No.
Zip Code: 32960 Fax: 772-978-9843
E -Maid: A
Phone No. 772-564-6980
E -Mail: SOUTHERNPLUMBING@AOL.COM
Fill in fee simple Title Molder on next page if different
from the Owner listed above)
State or County License: RFOO67100
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: x Not Applicable
Name: _
Address:
City:
Zip:
Phone:
State:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name: _
Address:
City:
Zip:
one:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
X Not Applicable
State:
BONDING COMPANY: x Not Applicable
Name:
Address:
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 wrice for
improvements to your property. A Notice of Commencement must b recorded and posted on the jobsite
before the fst inspection. If you intend to obtain financing, cons ith lender or an attorney before
commen work or recording your Notice of Commencement
�r/ ssee/Agent
STATE OF FLORIDA
COUNTY OF INDIAN xvFR
The for oing instrument was acknowledged before me
thisday of �_120 — y
(Name of person Rckn wledging )
(Signature Ofpotary Public{SS'ate of FloridQ
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
II• i�EtLY SAY
+ °e MY COMMISSION ir' FF241E65
EXPIRES June 16, 2019
Revised 07/15/2014=114071'sa '
Signa%, re -6f CfntractolLicense Halder
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
The forgoing instru ent was acknowledged before me
this a day of 20 IS by
` U
(Name of person ack owledging )
(Signature � Notary Publi(5tate of Fiorl(W)
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
KVftR LY MAY
MY COMMISSION # FF241666
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