HomeMy WebLinkAboutBuilding Permit Application Aug 03 1504:59p CRS Plumbing 772-460-7774 p.2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED op
Date: $`3-t$ Permit Number. lsba^ QWS
RECEIVED
•
Building Permit Application AUG 0A 2015
Planning and Development Services
Building and Code Regulation Division
2300 Virgin fa avenue,Fort Pierce FL 34982S:. �U
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential Xx
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 4200 N Al Unit 813
Legal Description:
Property Tax ID#: 1423-501-0157-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace existing hwh w!30 gal electric
CONSTRUCTION INFORMATION:
Additional work tobene orme under tispermit—checka appy:
HVAC LI Gas Tank []Gas Piping _Shutters a Windows/Doors
11 Electric 0 Plumbing Sprinklers ElGenerator Roof
Total Sq.Ft of Construction: Scl.Ft.of First Floor.
Cost of Construction:$ 850 Utilities: Sewer C15eptic Building Height:
OWNERf LESSEE: CONTRACTOR:
Name Christina M Thelon Name: Reed Sudderth
Address:3787 N Lakewood AveCompany: CRS Plumbing
City: Chicago State:IL Address: P.O.Box 12755
Zip Code: 60613-3716 Fax: City: Fort Pierce State:FL
Phone No.773-687-8029 Zip Code: 34979 Fax: 772-460-7774
E-mail: Phone No. 772466-7763
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.
Aug 0315 04:59p CRS Plumbing 772-460-7774 p.3
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGN ER/ENGIN EER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City, State:
Zip: Phone: Zip: Phone'
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: 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 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 recordingyour Notice of Commencement.
s
_Signa re of Owner/LesseeJAgent Signa re of Con actor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF .ST LuckZ COUNTY OF .:Pr. LUCEC
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 3 day of Au!s 20 S by this .3 day of Aug� 20 _[5_by
i
i
Edward D.Jend4- Edward D.Jendan
(Name of person acknowledging) (Name of person acknowledging)
I
ALJ
ignature of Notary Pu is tate of Florida) (Signature of Notary P Ii -State of Florida)
Personally Kno _ 'i Personally 'rte_ n
Type of Identifi 100 uLe"ARn n reur�n Type of Ide tiig'
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MY COMMISSION FF124587 ` i i*1 'MY COMMISSION#FcCFo72��7
Commission IN ti;� �: 5�RE8 Tea _19. 2018 Commissio ,fid! p�cz,_„c Myy 1S"'�1g8
(a o7)39e•0753 FlmitlallotaryService.com (.707)798.0753. %K&NIAMService.Cam
Revised 07/15/2014
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