HomeMy WebLinkAboutBuilding Permit Application Sep 23 15 03:33p CRS Plumbing . 772-460-7774 p.2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ! �j
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 XXX
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 5415 Pinetree Dr
Legal Description:
Property Tax ID#: 3402-602-0247-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Connect new water meter to residence.
CONSTRUCTION INFORMATION:
Additional work toe nertormed under this permit—check a appy:
HVAC Gas Tank F]Gas Piping _Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: S Ft.of First Floor.
Cost of Construction:$ 450 Utilities. Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name WashingtoNJeanettelKenneth Waters Name: Reed Sudderth
Address:5378 Ferrum Mountain Rd Company: CRS Plumbing
City: Callaway State:VA Address: P.O. Box 12755
Zip Code: 24067 Fax: Com: Fort Pierce State:FL
Phone No.772-370-1776 Zip Code: 34979 Fax: 772-460-7774
E-Mail: Phone No. 772466-7763
simple Fill in fee 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.
Sep 2315 03:34p CRS Plumbing 772-460-7774 p.3
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: —State-
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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 prohibitsuch
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 exemptfrom 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 our Notice of Commencement.
5
—Si aCre%f Owner/Lessee/Agent Signature of con radar/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF s1 Lube COUNTY OF stwoe
TheforrPPoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 2S day of SEP 20 LS by this a3 day of BSEP 20 _L'5�by
Edward D.Jendof- Edward D.Jendan
(Name of person ac wledging j (Name of person acknowledging)
�-
(Si nature of Notary Pub"- tate of Florida) (Si azure of Notary Public—(Oto of Florida)
Personally Known X OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Pr idu Type of Identification rve�'
e4r.
a?",�.`'•:°'s :L .J� '•ins}
EDWARD D-JENDUIT
MY 1ISSION#FF124587 ,�3 MY COM PN#FF12a5B7
Commission No. Commission No. gtil
; EXPIRES May 19.2018orr�dv EXPIRES May 19,2018
(407k398-0153 FlorldaNel (407)398.0153 Flatida"a1yService.com
Revised 07/15/2014
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