HomeMy WebLinkAboutBuilding permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/03/2020 Permit Number:
J, __
Building Permit AppliCation
Planning and Development Services
Building and Cede Regulation Division
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: 3113 S 22nd 5t.
Legal Description:
Property Tax ID #: 2428-602-0041-000-7
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No._
Block No_
I DETAILED DESCRIPTION OF WORK: I
Install 314" schedule 40 pvc pipe from house to meter.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check a apply:
HVAC Gas Tank []Gas Piping Shutters Windows/Doors
11 Electric!�� I Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: _
Cost of Construction: $ 280.00
S�Ft.{ of First
)J Floor: _
Utilities: Sewer Septic
Building Height:
OWNER%LESSEE:
CONTRACTOR:
Name George Landry
Name: Reed Sudderth
Company: CRS Plumbing
Address: 3118 S 22nd St.
,City_ Fort Pierce State: Fl.
Zip Code: 34982 Fax:
Phone No. 772-353-0445
Address: P.O. Box 12755
City: Fort Pierce State: FL
Zip Code: 34970 Fax: 772-460-7774
Phone No_ 772-466-7763
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Darner listed above)
E -Mail: crsplumbing(@bellsouth.net
State or County License. CFC1426853
If value of construction is %2 00 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: i Not Applicable
Name:
BONDING COMPANY: 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_
5t. 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,
accessary 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
commencing work or recording your Notice of Commencement.
XJ_1"M LAI/.[► s
_ Signa a of owner/ Lessee/Agent Sign re of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF st Lucia
The forgoing instrument was acknowledged before me
this ZO day of 20 I1by
Edward D.Jendon
STATE OF FLORIDA
COUNTY OF StLUC.
The forgoing instrument was acknowledged before me
this ZO day of � 10A) '20 � by
Edward D. dendon
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu c- State of Florida ) (Signature of Notary Puli - State of Florida)
Personally Known MMy
c t Personally KnownType of Identification P Type of Identification Pr. pubsmy COr"gfiN�omrd D Jena)3n
Commission No. n raCi 114514 Commission No,
Eex GG 178511
6 Expires ow 3r2022
Revised 07/15/2014
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