HomeMy WebLinkAboutBuilding Permit Application Dec 01 1506:28p CRS Plumbing 772-460-7774 p,2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a► 5 Permit Number:
RECEIV,:D DEC 012015
Building Permit Application
Planning and Development Services V01LJ
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)452-1578 Commercial XResidential
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 1107 S33rd St
Legal Description:
Property Tax ID# 2417-214-0007-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
In addition to install a 750 gal grease interceptor for compliance with health
department. This is a private sewer system. I
CONSTRUCTION INFORMATION: -
itiona war to e e orme un ert is permit—c ec all
appy:
0HVAC EGas Tank [:]Gas Piping _Shutters O Windows/Doors
Electric Plumbing OSprinklers O Generator Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 6704.65
Utilities OSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Cyril Thomas Name: Reed Sudderth
Address:9360101st Ave Company: CRS Plumbing
City: Vero Beach State:FL Address: P.O.Box 12755
Zip Code: 32967 Fax: City: Fort Pierce State:FL
Phone No.772-646-2215 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: crspiumbing@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.
Dec 01 1506:28p 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:."' j
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 holderto 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
cornme_ncing work or recording our Notice of Commencement:
s
_Sign ture of Owner)LesseeJAgent
Sig of Con or/License Holder
A6�61
STATE OF FLORIDA STATE OF FLORIDA
'COUNTY OF ST C.UC16 COUNTY OF LUC(ts
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this I day of aC 20 jc,_by this_L day of (}Ec .20 (S by
Edward D.Jendorf- Edward D.Jendon
(Name of person acknowledging) (Name of person acknowledging)
( ature of Notary Public-Sta o Florida) ( nature of Notary Public St a of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of identific tiuc Type of Iden 'fico `Pro uce
ED
ENDON
Commission No. MY COMMIS l fFF124587 Commission 's MY COMMISSION i( 5g7
''-' EXPIRES May 79 201 a
EXPIRES May 19,2Q18 ~•?oF, r y ,
ao7 399-tl15� FlarldeNwg Service. dol �oagrea vt
Revised.07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS