HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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:
Setbacks Front Back: Right Side:
Left Side:
[DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Acid itiona I work to be performed un er this permit— c eck
—]Gas
a apply:
1]HVAC Gas Tank Piping
_Shutters Windows/Doors
Electric ❑Plumbing ❑Sprinklers
Generator ❑ Roof
Total Sq. Ft of Construction:
S . Ft. of First Floor:
Cost of Construction: $ Utilities:n Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: Reed Sudderth
Address:
Company: CRS Plumbing
City: State: _
Address: P.O. Box 12755
Zip Code: Fax:
City: Fort Pierce State. FL
Phone No.
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.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone: -�-
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City. State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip:. Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
_Not Applicable
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
commencing work or recording vour Notice of Commencement.
L'``' s
_ Signa a of Owner/ Lessee/Agent Sign re of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF sr w�
The forgoing instrument was acknowledged before me
this 20 day of -Iy& , 20 IZby
Edward D. dendon
(Name ofperson acknowledging})
(Signature of Notary Pub c- State of Florida )
Personally Known ✓
Type of Identification P
Commission No. My corm+** yn CG 1.76514
Revised 07/ 15/2014
STATE OF FLORIDA
COUNTY OF sMude
The forgoing instrument was acknowledged before me
this Ze-> day of �__-- �UtJ 20 1� by
Edward D. dendon
(Name of person acknowledging)
e,
(Sigli- nature of Notary Pu State of Florida )
Personally Knowionn ✓Pr t-
Type of ldentifcatN*hvy Pub►
Edward f Elo�
Commission No. xpra s V=12 118514
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