HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE 7
Date: Pc
a
Building Permit Appl
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
it Number:
Residential xxxx
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 2410 St Lucie Blvd
Legal Description: SAN LUCIE PLAZA SID-UNIT ONE- BLK 56 LOT 1 (MA 14I28S) (OR 2269-2116)
Property Tax ID #: 1428-702-1212-000-8
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side:
Side:
Lot No.
Block No_
DETAILED DESCRIPTION OF WORK: I I
Run new water line from new city main to pump at house.
CONSTRUCTION INFORMATION:
Adaitional wor to e e orme un er t is per — c ec a app y:
❑HVAC Gas Tank ❑Gas Piping _ Shu tters ❑ Windows/Doors
❑ Electric ❑✓ Plumbing Sprinklers ❑ Generator Roof
Total Sq. Ft of Construction: SFt. of Fir t Floor:
Cost of Construction: $ 625.00 Utilities: LJ Sewelr 0 Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name Timothy Macomber
Name: Reed Sudderth
Address: 2410 St Lucie Blvd
Company: '',CRS Plumbing
City: Fort Pierce State: FL
Zip Code: 34946 Fax:
Phone No. 772-359-3378
Address: P.O. Box 12755
City: Fort Pierce State: FL
Zip Code: 34979 Fax. 772-460-7774
Phone No. 772-466-7763
E-Mail: crsplumbing@bellsouth.net
E-Mail:
Fill in fee simple Title Holder on next page [ if different
from the Owner listed above)
State or County
License: CFC1426853
If value of construction is 52500 or more, a RECURULU Notice or c.ommencemenL is requwreu.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATI
Name: _
Address:
City:
Zip:
INFER: _ Not Appl
Phone:
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: _
Address:
City:
Zip:
Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
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 authorizel'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 6unty 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
commencine work or recording your Notice of Commencement.
_ Sign re of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF stL
The forgoing instrument was acknowledged before me
this 30 day of tj 20 jL?—by
Frlward D_ Jendon
(Name of person acknowledging)
cense
STATE OF FLORIDA
COUNTY OF StLum
The forgoing instrument was acknowledged before me
this 30 day of MAy 20 1? by
Edward D. Jendon
(Name of person acknowledging)
(Sig ature of Notary lic- State of Florida } (Signature of Notary P b c- State of Florida )
Personally Known ✓ OR Produced Identification Personally Known `� OR Produced Identification
Type of Identification Type of Identification o uc
.M•'cyJl otary ubliC Stale of Florida
Notary P}+b4t fate of Florida `�. Edward en r?r
Commission No. EdwarA- -Adon
Commission No. MyComm�G t'73 t4
y My Commission GG 178514 w Expirrr-.
Vja Id; Expires 05/1912022
Revised 07/ 1512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS