HomeMy WebLinkAboutSLC - PERMIT APP 4-3-19ALL 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
PERMIT APPLICATION FOR: Plumbing
Address: 011
Legal Description:
Property Tax ID#:1��L-JUG' �p
Site Plan Name.
y
Project Name:
Setbacks Front - Back: Right Side: Left Side:
Residential
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: _J
-(,fie.. LA I I 'i ns{c a 5610 � 0++ I C J
hk(kk,K.
CONSTRUCTION INFORMATION
Additions war to aperformedunder thispermit - c ec all thatappy.
HVAC Gas Tank Das Piping Shutters Windows/Doors
11 Electric Plumbing ❑Sprinklers Generator Root
Total Sq. Ft of Construction: p S Ft. of First Floor:
Cost of Construction: $ 12-08.C�� Utilities:[]Sewer 0Septic Building Height:
OWNER/LESSEE:
CONTRACTOR: -
Name Q' e C I _I
Name: CRAIG MOBLEY
Address: rJ = -lir
Company: SOUTHERN PLUMBING, INC
City: )( State:
Zip Code: 329 LQ q Fax;
Phone No.
Address: 4069 43RD AVENUE
City; VERO BEACH State: FL
Zip Code: 32960 Fax: 772-978-9843
Phone No. 772-564-6980
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: SOUTHERNPLUMRING@AOL.COM
State or County License: RF0067100
, vmVC Vi wribirUCtiUH is 02500 ar mOre, a neWKUW Notice of commencement is required.
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,
accessary 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
STATE OF FLORIDA'
COUNTY OF INDIAN RIVER
The forgoing instrument was acknowledged before me
this _ day of 20 _by
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
The forgoing instrument was acknowledged before me
this _ day of 20 ^ by
(Name of person acknowledging ) I (Name of person acknowledging )
(Signature of Notary Public- State of Florida) I (Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced I Type of Identification Produced
Commission No.
Revised 07/15/2014
(Seal)
Commission No.
(Seal)
REVIEWS
FRONT
ZONING
y„
va 4^
VEGETATION
SEA TURTLE
MANGROVE
-.��
r--s;� r -ter... 3
DESIGNER/ENGINEER:
X Not Applicable
REVIEW
MORTGAGE COMPANY:
_
X Not Applicable
Name:
DATE
Name:
Address:
Address:
COMPLETE
City:
State:
City:
_
5tate:
Zip: Phone:
INITIALS
Zip: Phone:
_
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.
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,
accessary 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
STATE OF FLORIDA'
COUNTY OF INDIAN RIVER
The forgoing instrument was acknowledged before me
this _ day of 20 _by
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
The forgoing instrument was acknowledged before me
this _ day of 20 ^ by
(Name of person acknowledging ) I (Name of person acknowledging )
(Signature of Notary Public- State of Florida) I (Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced I Type of Identification Produced
Commission No.
Revised 07/15/2014
(Seal)
Commission No.
(Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS