HomeMy WebLinkAboutBUILDING Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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 xxxx
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 5710 Palmetto Dr
Legal Description: INDIAN RIVER ESTATES-UNIT 06-BLK 20 LOTS 9 AND 10 (MAP 34/11 N) (OR 376-411)
Property Tax ID##: 3402-607-0162-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace existing 80 Gal solar Hot Water Heater
CONSTRUCTION INFORMATION:
Additional work to be e orme under this permit—check all h t apply:
11HVAC Gas Tank DGas Piping _Shutters Windows/Doors
Electric ❑✓ Plumbing Sprinklers El Generator hoof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1245.00 Utilities. —Sewer 11 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Charlene S Neuman Name: Reed Sudderth
Address:5710 Palmetto Dr Company: CRS Plumbing
City: Fort Pierce State:FL Address: P.O. Box 12755
Zip Code: 34982 Fax: City: Fort Pierce State,FL
Phone No_772-461-6493 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: crsplumbing@bellsouth.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 TITLEHOLDER: 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,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
commencing work or recording our Notice of Commencement.
s
_Sigrialture of Owner/Lessee/Agent Signat<ite of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF stLucie COUNTY OF st—
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 26 day of F5 20 (?--by this 2b day of JUrJ 20 N9 by
Edward D.Jendon Edward D.Jendon
(Name of person acknowledging) (Name of person acknowledging)
'' 44
(Sig ature of Notary Publi -S ate of Florida) ( ignature of Notary u lic-State of Florida)
Personally Known ✓ OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Pr u e. Type of Identification t V
* ��r r Notary Public State of Florida
6 otary Public State of Florida o Edward of on
Edw rd kendon Commission No. 4 r My Com G 17e514
Commission No. . r My sionGG17851a
Expires 05119/2022 j ''i no Expires GSIIW2022
ve^ ./
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE COMPLETE
INITIALS