HomeMy WebLinkAboutbuilding permit ALL 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 XXX
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 1823 Bar Harbor(Part of 1001 Angle Rd-Golden Ponds)
Legal Description: 3 35 39 NW 1WLESS AVON MANOR-UNITS 1 AND 2 AND LESS W 615.5FT LYG S OF AVON MANOR-UNIT 1
AND LESS CANAL AND RD RSIW AND LESS 1-95AS IN OR 237-1372-(99.02 AC)(OR 630-131)
Property Tax ID#: 2303-211-0025-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:.
DETAILED DESCRIPTION OF WORK:
Connect water meter to residence per FPUA.
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit—check all th apply:
F1HVAC Gas Tank ❑Gas Piping IL_i!Shutters L1 Windows/Doors
❑Electric ❑ Plumbing Sprinklers Generator ❑�Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 300.00 Utilities:[]Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Pershing Mobile Home Sales Inc. Name: Reed Sudderth
Address:901 NW 31stAve Company: CRS Plumbing
City: Pompano Beach State:FL Address: P.O. Box 12755
Zip Code: 33069 Fax: City: Fort Pierce State:FL
Phone No. Zip Code: 34979 Fax: 772-460-7774
E-Mail: Phone No. 772-466-7763
Fill in fee simple Title Holder on next page(if different E-Mail: crspiumbingabellsouth.net
from the Owner listed above) State or County License. CFC1426853
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required_
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,1 do hereby agree that I will, in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St_ Lucie County Amendments_
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recorqLngyour Notice of Commencement.
�r460 � � s
_SigatuA of Owner Lessee/Agent Sign Lie of Contractor/license Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF st--- COUNTY OF St Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this �2S day of J u I,-I 20 18 by this 2$' day of J u t1 20 1 by
Edward D.Jendcn Edward D.Jendon
(Name of person acknowledging} (Name of person acknowledging}
+:
(sign tune of Notary Public-S a e of Florida} (Sig ature of Notary Public- t to of Florida)
Personally Known OR Produced Identification Personally Known OR Produced identification
Type of Identification P Type of Identification trey.
,►Rr�4._ of Public State pf Floridan►*' Notary Public State of Florida
Commission No. Edwar ,�1�ndart Commission No. Edward on
MY Coon GG 118514 :; e� My Commission G 178514
''ram nct Expires 051tgl2022 VT'
Expires 05/1812022
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
1[INITIALS