HomeMy WebLinkAboutBuilding permitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/14/19 Permit Number:
4 J'
•
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 X Residential
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 4520 Selvitz Rd -
Legal Description:
Property Tax lD #: 2432-332-0001-000-0
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No --
Block No-
I DETAILED DESCRIPTION OF WORK: I
Replace existing 50 gallon electric hot water heater, located in the electrical/maintenance room.
CONSTRUCTION INFORMATION:
Add itiona I wo rk to e e o—rim ed u nd er th is permit — check a apply: Gas Piping _ Shutters ❑ Windows/Doors
F1HVAC Gas Tank
11 Electric ✓❑ Plumbing Sprinklers E Generator Roof
Total Sq. Ft of Construction:
Cost of Construction. $ 1050.00
S Ft. of First Floor: _
Utilities: Sewer ElSeptic
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name St. Lucie County Brickhaven Enterprises Inc.
Name: Reed Sudderth
Address: 2300 Virginia Ave.
Company: CRS Plumbing
City: Ft- Pierce State: FI
Zip Code: 34982 Fax:
Phone No. 772-460-9752
Address: P.O- Box 12755
City: Fort Pierce State: FL
Zip Code: 34979 Fax: 772-460-7774
phone No- 772-466-7763
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: crsplumbing(pbellsouth.net
State or County License: CFC1426863
49 VCHUC u1 W11MMULL101I M ?Z-OUV or mare, a KtLUKUtU Notice of LOmmencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
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 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 recordine your Notice of Commencement.
Sign re of Owner/ Lessee/Agent Signa 0 of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF -s Lucie
The forgoing instrument was acknowledged before me
this _ day of , 20 (% by
STATE OF FLORIDA
COUNTY OF st—i-
The forgoing instrument was acknowledged before me
this S day of ley 20 LL by
Edward D. Jendon Edward D. Jendon
(Name of person acknowledging } (Name of person acknowledging)
C �
(Signature of Notary Pubbo State of Florida) (Signature of Notary Pu ' - state of Florida }
Personally Known ✓ OR Produced Identification
Type of Identification P
4 r,►er Notary Public State of Figrida
Commission No. Edwa2dridon
My Co ini55i n GG 178514
Expires 05119/2022
Revised 07/ 15/2014
Personally Known ✓ Pr d I e fi a i
Type of Identification Pr uc
ataly UvicSlate raffrori
Edward D Jendon
Commission No. My Com GG 178S14
• w F Expires 05119r 22
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