HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 41 �Ay Permit Number: ( 4& V/0.>—
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Building Permit Application -APR •7 2016
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 XXXX
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT,LOCATION
Address: 3550 S Brocksmith Rd
Legal Description: See Attached
Property Tax ID#: 2329-501-0006-010-9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED-DESCRIPTION OF---,WORK:--
IJ
Replace cast iron pipe w/PVC DWV pipe.
CONSTRUCTION INFORMATION
Aciclitionalwork,tobenertormedunder this permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 2400.00 Utilities: Sewer Septic Building Height:
OWNER/LESSEE:,y „' CONTRACTOR:
Name Keith J Schemenauer Name: Reed Sudderth
Address:2855 NW St Lucie Ln Company: CRS Plumbing
City: Stuart State:FL Address: P.O.Box 12755
Zip Code: 34994 Fax: City: Fort Pierce State:FL
Phone No.904-233-7037 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: CFC1426853
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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:
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 thea C-1—-^a CF '..
approved plans,the F ori '^� ue County Amendments.
The following building permit applications are a 1ncurrency review:room additions,
accessory structures,swimming pools,fences,v� �' cessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a:.IVatice.a#,Ggmenfement may result in your paying twice for
improvements to your property.A Notice:of Cry ;trier ;: gtrxtust be recorded and posted on the jobsite
before the first inspection. If you intend.- ob art ina�c� onult with lender or an attorney before
comme ' work or ecord in our once o. tmfiene nt"✓_,
s
_Signature of Owner/Lessee/Agent Signature of Contr or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF stLucie COUNTY OF st-
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 6 day of APlL , 20 lb by this 6 day of APti ,20 /6 by
Edward D.Jendo+- Edward D.Jendon
(Name of person ac owledging) (Name of person acknowledging)
f� -
( nature of Notary Publ0late of Florida) ( - nature of Notary Pub ic- tate of Florida)
Personally Kn yJv�YGb �{ge�ljfijp Pers rall �A- _'d&PANgMr tification
Type of[dent i4i t?�.ads TypeftiaWn44liM9IpN#FF124587
�, ;oma; 4�,;,d;• EXPIRES May 19, 2018
' EXPIRES Ma 19 2018 Com 931isltsa Ftaridallota Service.com Sal
Commission o. ^••,•, Seal�.co )
(4 eNote rvic m
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS