HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��
Date: 'C ,. �_ )a Permit Number: ) c�•oy/ 0
CEI VE
Building Permit Application DEC 2 3 2015
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 X
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION
Address: 103 DEVONSHIRE COURT
Legal Description: SHERATON PLAZA UNIT 2 REPLAT LOT 75 (OR 1440-1043; 3547-2325)
Property Tax ID#: 1432-805-0075-000-7 Lot No.75
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED.-DESCRIPTION OF WORK. ,
EXCAVATE AND REPLACE SEWER FROM HOUSE TO CITY CITY WITH PVC PIPE
CONSTRUCTION LNFORMATION
„ .
Additionalwork to be nerformed un er this permit—check all appy:
HVAC Gas Tank DGas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing OSprinklers �Generator �Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction: $ 1690.00 Utilities: Sewer E]Septic Building Height:
OWNER.LESSEE CONTRACTOR:
Name EVANGELIA M JACKSON Name: CRAIG MOBLEY
Address:103 DEVONSHIRE COURT Company: SOUTHERN PLUMBING, INC
City: FT PIERCE State:FL Address: 4069 43RD AVENUE
Zip Code: 34946 Fax: City: VERO BEACH State:FL
Phone No. 23 -' Zip Code: 32960 Fax: 772-978-9843
E-Mail: Phone No. 772-564-6980
Fill in fee simple Title Holder on next page(if different E-Mail: KMAY.SOUTHERNPLUMBING@GMAIL.COM
from the Owner listed above) State or County License: RF007100 // 18928
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPI.EMENTAI.�CONSTRUCTION LIEN LAW �NFORMATION:
DESIGNER/ENGINEER: _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:
1 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 Horne 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 Comrnencement must recorded and posted on the jobsite
th
before st inspection. If you intend to obtain financing,cons ith lender or an attorney before
comme I work or recordingour Notice of Comm encemen
S
Si=natofner/Le ee/Agent Signa Co actor/Lice a Holder
STAIDA_ STA OF FLORIDA
COUNTY OF i R J I ah V)VCS COUNTY OF INDIAN RNER
Theforgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 28 day of D kKV" . 20 j.g_by this 22`` day of DECEMBER .20 K by
CRAIG MOBLEY
(Name of son acknowl dging) (Name of person acknowledging)
film my I! V
(Signa Notary P lic-State o Florida) (Si natu e f Notary P lic-State o iorida}
Personally Known J_OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. $ 'f' • K"1*L_Y 1N'A11Y Commission No. FF241665 BitLY MAY
�•: «-MY COMMISSIONFF241686 ' '
'"" •'z MY COM1 ISSION 0 FF2418
EMREB,JUA*is,• •,
(407)39"153aen, vert 98o+s3 Jitr« $,20f8
Revised 07/15!201
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW: REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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