HomeMy WebLinkAboutBuilding Permit Application Jan 2916 03:44p CRS Plumbing �'r"`' 7.72-460-7774 p.1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ) r
Date: 1129116 Permit Number:
• PLEASE CALL WHEN REA
Building Permit Application q�
Planning and Development Services JAN ¢ 9 2p16
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: 9117 Pumpkin Ridge Rd
Legal Description- MAIDSTONE(PB 43-11) LOT 68(OR 2157-397)
Property Tax I D#: 3322-505-0077-000-8 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace existing 50 gal tall electric HWH
CONSTRUCTION INFORMATION:
��itiona workto e e orme under is permit—c ec a appy:
11HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric E]Plumbing ❑Sprinklers Generator Roof
Total Sq. Ft of Construction: Ft. of First Floor:
Cost of Construction:$ ��S• '017 UtilitiesSewer El Septic Building Height:
OWNERf LESSEE: CONTRACTOR:
Na me Albert ALorefice Name: Reed Sudderth
Address:9117 Pumpkin RDG Company: CRS Plumbing
City. Port St Lucie State:FL Address: P.O.Box 12755
Zip Code: 34986 Fax: City: Fort Pierce State:FL
Phone No.772-418-0353 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: crsplumbing@bellsouth.net
from the Owner listed above) State or County License: CFC1426863
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Jan 2916 03:44p CRS Plumbing 772-460-7774 p.2
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 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 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,
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 recording our Notice of Commencement.
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_Sign a of Owner/Lessee/Agent Signatu of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF s,L-a COUNTY OF stt„aa
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 2g day of JAIM . 2016 by this ZS dayof JAm 20&_by
Edward D.Jand4- Edward D.Jendan
(Name of person acknowledging) (Name of person acknowledging— LxVV'o aQL-_� 9�u�"_ tL
)
(Sign tune of Notary Public- of Florida) ( ' nature of Notary Pub c- tate of Florida)
Personally Kno Personally Kn
Type of Identi o rodu&f(CLQMM Type of Identi ciPo
+� "' MY COMMISSION c#FF1124587
+'+`usM1dk°� EXPIRES Md 19,2018 ;�._._.,'.A'.
Commission N II11 Commission N ..? �:.' cvoiaES May§VIEo16
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(407)3913.0t53 F46dd9NotarySetvicecom
Revised 07115/2014
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