HomeMy WebLinkAboutBuilding Permit Application pate: Permit Numoer:
Building Permit Application RECEIVED
Planning and Development Services
Building and Code Regulation Division S�i 2 5 Z018
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Reside tW �4P
County, Permitting
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 3601 Wildemess Drive West
Legal Description: See Attached
Property Tax ID#: 2433`221-0005-040-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Connect FPUA meter to customer's house.
CONSTRUCTION INFORMATION:
Additional work toe performed under this permit—check a appy:
❑HVAC F]Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric ❑✓_Plumbing Sprinklers FIGenerator Q Roof
Total Sq. Ft of Construction: t. ,
of First Floor:
Cost of Construction:$ 575.00 UtilitieSewer Septic Building Height:
OWNER/LESSEE: _ CONTRACTOR:
Name Ronald Dillon Name. Reed Sudderth
Address:3601 Wilderness Drive West Company: CRS Plumbing
City: Fort Pierce State:FL Address: P.O. Box 12755
Zip Code: 34982 Fax: City: Fort Pierce State:FL
Phone No.772-519-3818 Zip Code: 34979 Fax: 772-460-7774
E-Mail: Phone No_ 772466-7763
FII in fee simple Title Holder on next page(if different E-Mail: crspiumbing(§bellsouth.net
from the Owner listed above) State or County License: CFC1426853
If value of construction is$2.500 or more,a RECORDED Notice of Commencement is required.
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,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
comm in w rk recordi our Notice of Commencement.
lits
_Signature of Owner)Lessee/Agent Sig a ure o Contra or License der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF sA— COUNTY OF &—
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this A day of .a tp20 1s-by this day of 20 _Zyby
Edwafd D.Jendon Edward D.Jcadon
(Name of person acknowledging) (Name of person acknowledging)
Z777:-- - S�zu'0'M'Vx'W_
(Signature of Notary Pub of Florida) (Signature of Notary /0U151ic-SiWe of Florida )
Personally Known OR Produced Identification— Personally Known_.V� OR Produced Identification
Type of Identification Produced Type of Identification Pr
NotaryP I SYdAcorfionr.
Commission No. NobrY Pubo"80 0710 da Commission No. 1-11, Edon
ro 0.tendon , My Cunvn aeon GG 17 W 4
MY COM MssanGG/78514 +1Expims 051194022
Revised 07/15,12014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE -----___.
COMPLETE
INITIALS