HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1((`��
Date: 8/1219 Permit Number: `` U-7 1 01 &-a
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
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 4701 Pinetree Dr.
Legal Description: Indian River Estates
Property Tax ID #: 3402-605-0074-000-9
Site Plan Name:
Project Name:
Setbacks Front Back:
Commercial Residential X
Right Side: Left Side:
Lot No. 9
Block No. 36
DETAILED DESCRIPTION OF WORK: I
Remove and replace existing 50 gallon electric hot water heater in warranty.
CONSTRUCTION- INFORMATION:
Additional work to be nerformed un er t is permit — check
FHVAC Gas Tank ❑Gas Piping
all
apply:
Shutters
Q Windows/Doors
❑✓
OSprinklers
_
1:1 Generator
EIRoof
Electric Plumbing
Total Sq. Ft of Construction:
S�Ftj of First Floor:
Cost of Construction: $ 500.00
Cost
Utilities: —Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR: _
Name Patrick Cuoco
Name: Reed Sudderth
Address:4701 Pinetree Dr.
Company: CRS Plumbing
City: Fort Pierce State: F�
Address: P.O. Box 12755
Zip Code: 34982 Fax:
City: Fort Pierce State: FL
Phone No. 772-359-3185
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: crsplumbing@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
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 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, cons lender or a orney b
commenp,ngwprk Qr reofoing your Notice of Commencem
s
_ Signature of Ownerf Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF &Lud- a
I
The forgoing instrument was acknowledged before me
this A-.',�— day of 20 _jSy
(Name of person acknowledging )
17N1,
(Signature df Notary Public- StatdL,�f Florida )
i
Personally Known OR Produced Identification
Type of Identification Produced
No.
Revised 07/15/2014
VASHAHNA INGRAM-RAHMING
MY COMMISSION 4 GG 275060
Bonded Thru Notary Public Underwriters
STATE OF FLORIDA
COUNTY OF stwcre
The forgoing instrument was acknowledged before me
this ��day of 20 _ 1�_ by
IL
(Name of person acknowledging)
P I
(' ture of Notary Public- Slote of Florida )
Personally Known OR Produced Identification
Type of Identificati { _
mission No.
December'
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS