HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO RE ACCEPTED
Bate; 4 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Vlrglyda Avenue, Fort Plerce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-157$
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LU(�AI [VIN:
Address:
LefW Description;
Commercial _ Residential
Property Tax I D #: ZI ' 1 y
Site Plan Name:
Project Name:
Setbacks Front . Back: Right Side
I DETAILED° DESCRIPTI'O'N OF MAX:
Left Side:
P�Lphu' z'G Ull-14
Lot No..�_q
Block No,
itional work oe ger orme .. un er this permit --check all that apply;
HVAC E]GasTank ElGas Piping OShutters Windows/Doors
iJElectric R] Plumbing Sprinklers FIGenerator Roof
Total Sq, Ft of Construction: r/
Cost of Construction: $
SFt. of First Floor:
UtilitiestSewer OSeptic
Building Height:
OWNER/LESSEE
CONTRACTOR`:
e
Name: CRAIG MOBLEY
NaMess:
Company: SOUTHERN PLUMBING, INC
City: NNOlk, S,tate:
Address: 4069 43RD AVENUE
Zip Cade: Fax:
City; VERO BEACH State; EL
Phone No,
Zip Cade: 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
State or County License: RF0067100
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
ENRONE
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
DESIGNER/ENGINEER. x
Not Applicable
MORTGAGE COMPANY:
X Not Applicable
Name:
REVIEW
Name:
REVIEW
Address:
REVIEW
Address:
City:
State:
City:
State: _
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X
Not Applicable
BONDING COMPANY:
x Not Applicable
Name:
Name:
Address:
City:
Address:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior tothe 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 nor -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 ' st inspection. If you intend tq obtain financing, corsAft with lender or an attorney before
commen R work or recording our Notice of Commencemen
_ Signatwfe of 0%ner/ Ldssee/Agent
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
The forgoing instrument was acknowledged before me
this I;} day of _ 20 �8 by
(Name of peroJn acknowledting )
(sig t re f -data ublr ate of Florida )
Person Ily Known
Type of Identificatio
Commission No.
Revised 07/15/2014
OR Produced Identification
Notary PubHG 810% of Florida
L<ristin Ky1 $bb
my Commissw GG 177256
Expires 01 (21/2022
tractor/Vicense Holder
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
The forging instrument was acknowledged before me
this l4 day of , 20 $ by
(Name
PersonalIV Known
Type of Identificai
Commission No. "0&
OR Produced Identification
NGtery Public SSof F pride
1Sr,V, Kyb W_"Ga l�
My Commmsion GG 17725e
Elsplre� 01nif2o2z
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVIE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS