HomeMy WebLinkAboutBuilding Permit ApplicationAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
te: 8' la' I q 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 Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the .end of line
PROPOSED IMPROVEMENT. LOCATION:
Address: 9434 Windrift Circle
Legal Description. Palm Breezes Club
Property Tax ID #: 2310-500-0051-000-5
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK: ,
Right Side: Left Side:
Lot No. 9
Block No. 2
Remove and replace existing 40 gallon electric hot water heater. Heater supplied by owner.
CONSTRUCTION INFORMATION:
n .t..,.. .—A,tr.1,o Fm-Airnrinrt is nAarmit chiorli, all t nt nnn r
LjHVAC Lj Gas Tank
E]Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 400.00
Gas Piping ❑ Shutters ❑ Windows/Doors
Sprinklers FIGenerator E]Roof
S Ft. of First Floor: _
Utilities:Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR: :.
Name Don Graham
Name: Reed A. Sudderth
Address: 9434 Windrift Circle
CRS Plumbing
Company: 9
City: Fort Pierce State: Fl
Address: PO Box 12755
;Zip Code: 34945-3304 Fax:
City: Fort Pierce State: Fl-
Phone No. 772-579-3470
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
lumbin
E-Mail: crs P 9@bellsouth.net
from the Owner listed above)
State or County License: 3091
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:
Zip: Phone:
City: State:
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 ' re to cord a Notice of Commencement may result' r paying twice for
improvements to your pro rty. A Notice f Commencement e r corde o e e jobsite
before the first inspecti If you intend to btain financin , consult wit lend r or an torney be re
com cin or ore in our N tic of Co en ment.
s
_ Signature of Owner/ Lessee/Agent Signature of Contra r/License Holder
STATE OF FLORIDA STATE OF FLORIDA j
;COUNTY OF .I,& COUNTY OF
The forgoing instrument was acknowledged before me
this 14% day of Q M 20 by
(Name of person acknowledging)
(SiJdatuke of Notary Public- StAte of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
Revised 07/ 15/2014
The forgoing instru ent was acknowledged before me
this JMday of 20 by
(Name of person acknowledging)
of Notary Publi&�State of Florida
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
(Seal)
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