HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �\� Permit Number:
RECEIVED
Building Permit Application Aug o ?119
Planning and Development Services
Building and Code Regulation Division ` gT, 6uglo co -prtnittingr
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing
,PROPOSED IMPROVEMENT LOCATION:
Address: 9940 South Ocean Drive Unit 110
Legal Description: Oceana Oceanfront Condominium One Apt.110
Property Tax ID#: 4502-502-0017-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: .
Replace existing 30 Gallon Electric Hot Water Heater
CONSTRUCTION INFORMATION:
Additional work to be nertormed under tis permit—c ec a - appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric Plumbing Sprinklers F]Generator E] Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 950.00 Utilities:n Sewer E Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name William Whiteford Name: Reed Sudderth
Address:1142 River Bay Rd Company: CRS Plumbing
City: Annapolis State:Md. Address: P.O. Box 12755
Zip Code: 21401 Fax: City: Fort Pierce State:FL
Phone No. 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: crspiumbing@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 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 thepermit 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 inspe If you intend to obtain financing,consult with lender or an attorney before
comme ork WrerqbringXor otice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFstwde COUNTY OF stLucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this `N day of Qy 20 n-by this6 day of c:k!?n ,20 `\ by
Q �V_ S')-\ �-,s -N-h
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Puft--State of Florida) (Signature of NotaYy Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification.,--_
Type of Identification Produced T '- L ,ype of Identification Produced `
DU1N A ratr r 16 CG 67'e};=
ENS �v Pae'o, Y C �A s vN X97.@
Commission No.(sC1d�.�.d�3 R N� �y Jr- 22pZ� mmission No. o ._ � �e�4�e,nb�t
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Revised 07/15/2014
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