HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATIONSep 1514 06:42p CRS Plumbing
772-^P^4 7774 p,2
Date: C9 Fee Due: Recei t# I Permit # VA a , Gaza
Planning & Development Services
sn - J �1 J Building & Code Regulations Division SC
2300 Virginia Ava _11V
Fort Pierce, FL 34982 FQ
(772)462-1553 Fax 462-1578 �/��O
Co4n�y
SPECIALTY PERMIT APPLICATION
❑ Electrical ® Plumbing ❑ HVAC ❑ Fence
❑ Shed* ❑ Demolition ❑ Gas ❑ Siding
Seepage 2for instructions and additional paperwork required for specialty permits
1. Location/Site Address: 425 Bartow
2. Parcel ID Number:
3402-603-0147-000-6
3. Complete Description of Project or Work: Re -pipe w/cpyc pipe - hot & cold water
4. Owners Information S. Contractors Information
Name: Rosalinda Schwab FLReg/Cert0:
Address: 425 Bartow County Cert*:
City: Fort Pierce State: FL Business Name:
Zip:
34979
CFC1426853
CFC1426853
CRS Plumbing
Phone: 772-465-7676 Phone:772-466-7763 Fax: 772-460-77ZA
b. Value of Construction: S 950.00
OWNER'S AFFIDAN,Tr: I certify that all of the information contained in this application is correct and that all work will be done in
compliance with all applicable laws regulating construction d'zoning.
Reed Sudderth
PRINT OWNER OR CONTRACTOR NAME SI TURF OF R CONTRACTOR
STATE OF FLORIDA, COUNTY OF St. Lucie
ACKNOWLEDGED BEFORE ME THIS DAY OF 5C- P 20-a- BY REED ED 60 00 G12{+i
WHO IS PERSONALLY OWN TO ME OR WHO HAS PRODUCED __._,_ •_.._.. _•
4S - IFICATION.
Edward D. Jendon (seal)
SI OF NOTARY . OF NOTARY
,N EDWARD D JENDON
COM&ffSSION NIIMDCR
t r; MY COMMISSION #FF124587
EXPIRES May 19, 2018
*ALL RESIDENT.IAL AND NO e ' UR IED TO MEET THE FLOOD 7.ONR
ELEVATION OR 19INCHES ABOVE THE CROWN OF THE ROAD, WIHCIIEVER IS APPLICABLE. (see instructions on
reverse side of this sheet)
Revised 03/1812014