HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: —2-12 Permit Number:
lip I It
Building Permit Application
Planning and Development Services
Building and Lode Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 /
Phone; (772) 462-1553 Fax: (772) 462-1578 Commercial v' Residential
PERMIT APPLICATION FOR: Plumbing
Address; 5 1 lo–I N• H i Ct (14 ° a A t A
Legal Description: OCPArl�iiAY4nolki' }(•tAler- ('( nclC)tvAi() : 11 IInjt- tot
(Cr 12 5 -1 -ti -1)
PropertyTaxlD#:1911-7109 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
I,v SuiDply inievN AO�att0 Ctec1 rIrc r
Y�eat er
nn HVAC 1:1 Gas Tank ❑Ga:
I�IElectric Plumbing ❑Spi
Total Sq. Ft of Construction:
Cost of Construction: $ 1 , I Z U • OC7
Piping UShutters ❑ Windows/Doors
nklers El Generator Roof
SFt. of First Floor:
Utilities:cnSewerUSeptic BuildingHei¢ht:
CW N E R/LESSEE:
CONTRACTOR:
Name 10 Y1 ri iLt xar n P 2 r r1
Name: CRAIG MOBLEY
Address:..5 t y, -1 N. A t A A JP i tot
Company: SOUTHERN PLUMBING, INC
City: jaOyr P j C cc e, State: F L
Zip Code: 390 p of Fax:�l I %
Phone No. '-1-12 -z-i J,F5- -1-112
E -Mail: N I
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If value of cnnstrurtinn is 16cnn „r r...,rm � uernnncn .,_,__ _.
Address: 4069 43RD AVENUE
City: VERO BEACH State: FL
Zip Code: 32960 Fax: 772-978-9843
Phone No. 772-554-6980
E -Mail: Y- r" 3Y - SOOTh e r n Pk —V M-12-�it-11� ac, j �o
State or County License: RFo067100 –'
__ _. ___ _, - mr c4uucu.
I certify that no work or installation has commenced prior to the issuance of a permit.
which is In conflict with any applicable Home Associations permit will
orthe
dpcovenants thto at maydrthe estr restrict or prohibits ch
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 exemptfrom 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 th first inspection. If you intend to obtain financing, consiy�t with lender or an attorney before
omme n
cwork or recording your Notice of CommencPmPnt//
Lessee/Agent
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
The forgoing instrument was acknowledged before me
thisdayof Ft hru dry 20 E -by
!L
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
The forgoing instrument was acknowledged before me
this 20ayofEthY UaYy 201 1 by
(Name of person
laignac 7e or rvotary ruoNc- ate - u e of Notary Public -tate of FloridT-)
Perso Ily Known OR Produced Identification Personal Known OR Produced Identification
Type of Identification Produced Type of dentification Produced
Commission No. '' '��(SVNM{ryPum.SbteofFion C mission No. Cy(=��-I'7 �„ y,. e
Kri n Kylie We C6 ' Mary R
h a My Commmsiw GG 177256 � Kdslin K
Revised 07/15/2014
of
REVIEWS
'i
WIN � ,rye yy
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
DESIGNER/ENGINEER. x_
Not Applicable
MORTGAGE COMPANY:
x Not Applicable
Name:
REVIEW
Name:
REVIEW
Address:
Address:
City:
Zip: Phone:
State:
City:
State:
COMPLETE
Zip: Phone:
v
FEE SIMPLE TITLE HOLDER: x
Not Applicable
BONDING COMPANY:
x 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.
which is In conflict with any applicable Home Associations permit will
orthe
dpcovenants thto at maydrthe estr restrict or prohibits ch
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 exemptfrom 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 th first inspection. If you intend to obtain financing, consiy�t with lender or an attorney before
omme n
cwork or recording your Notice of CommencPmPnt//
Lessee/Agent
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
The forgoing instrument was acknowledged before me
thisdayof Ft hru dry 20 E -by
!L
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
The forgoing instrument was acknowledged before me
this 20ayofEthY UaYy 201 1 by
(Name of person
laignac 7e or rvotary ruoNc- ate - u e of Notary Public -tate of FloridT-)
Perso Ily Known OR Produced Identification Personal Known OR Produced Identification
Type of Identification Produced Type of dentification Produced
Commission No. '' '��(SVNM{ryPum.SbteofFion C mission No. Cy(=��-I'7 �„ y,. e
Kri n Kylie We C6 ' Mary R
h a My Commmsiw GG 177256 � Kdslin K
Revised 07/15/2014
of
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS