HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE IN/F,O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I
, 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
PERMIT APPLICATION FOR: plumbing —�
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID #: — Lot No. _
Site Plan Name: Block No.
Project Name: Q Q I-&
Setbacks Front Back: Right Side: Left Side
DETAILED DESCRIPTION OF WORK: —1
CONSTRUCTION INFORMATION:
tiona wor to a er orme un er t is permit c ec a app y:
1JHVAC f Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
Electric ❑✓_Plumbing ElSprinkiers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 16� A 013 Utilities:11Sewer OSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name W-Nlb -lb
Name: CRAIG MOBLEY
Address: `t
41
Com an SOUTHERN PLUMBING, INC
P Y
City: State: FC
Zip Code: Fax:
Phone No.. 2 — 7 0S— )/S_7
—
Address: 4069 43RD AVENUE
City: VERO BEACH State: FL
Zip Code: 32960 Fax: 772-978-9843
Phone No. 772-564-6980
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If .,eL m of' .�.
E-Mail: SOUTHERN PLUMBING@AOL.COM
State or County License: RF0067100
-, - .. �_ ,w%16c V, bViff,LUCLRCLLLCUL is requLrea.
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DESIGNER/ENGINEER:
Name:
x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
x Not Applicable
BONDING COMPANY: x Not Applicable
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 Count 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 OWN ER: 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
comr961cing work or recording vour Notice of Commencementeol
of Owner/
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
The forgoing instrument was acknowledged before me
this S� day of NOVCWYI 13fY . 20 ►gby
(Name of n acknom
(sign ure of N ary Pul
Per o Ily Known
Type f Identification Pr(
Commission Noklm
Revised 07/15/2014
OR Produced Identification
STATE GIELLO 1DA'
COUNTY OF INDAN RIVER
The forgoing instrument was acknowledged before me
this y` day of UDVCYY1h -r .20 101 by
(Name
Perso" Ally Known _(
Type of Identification
M
Public-
OR Produced Identification
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS