HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: off . Permit Number:
Building Permit Application APR 2 1 2016
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (7i2)462-1553 Fax:(772)462-1578 Commercial Residential XXXX
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION"
Address: 1808 N 49th St
Legal Descr Option: HARMONY HEIGHTS BLK N LOTS 12 AND 13(0.26 AC)(OR 363-2524)
Property Tai ID#: 2406-502-0212-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Bring sewer line to code.
CONSTRUCTION INFORMATION
Additional orktobenerformed under 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:$ 350.00 Utilities Sewer Septic Building Height:
OWNER/LESSEE': CONTRACTOR :.,
Name Paul E Dale Name: Reed Sudderth
Address:1808 N 49th St Company: CRS Plumbing
City: Fort Pierce State:FL Address: P.O.Box 12755
Zip Code: 34947 Fax: City: Fort Pierce State:FL
Phone No. 72-577-1747 Zip Code: 34979 Fax: 772-460-7774
E-Mail: Phone No. 772-466-7763
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Fill in fee simple Title Holder on next page(if different E-Mail: crs P 9@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.
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SUPPLEMENTAL CO"NSTRUCT(ON LIEN LAW INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: I Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
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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 Cou �y 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.PIase 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 str�lctures,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
commenc rk or rpr
ording otice of Commencement.
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_Signature of Owner/Lessee/Agent actor/License Holder
ture of Con ra
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOFstLude COUNTY OF StLude
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this V day of A rR 20 /bby this_�L day of Af fZ ,20 /C by
Edward D.Jendo� Edward D.Jendon
(Name of pe son acknowledging) (Name of person acknowledging)
f& �_)QQW��_
ignature of Notary Publi t/11te of Florida) (Signature of Notary Publi S to of Florida)
Personally Known Q4 ^ oucecl la
q, ucenJENDO
Personally Known Oentincatlun
4^ ..... DWARD D JENDON
Type of Identification Pr siQe EDWARD Type of Identification Pro t '' '':�_:MY COMMISS •.. - :o,= MY COM SION#FF124587
MISoCommission No. "°'.'t'" :` EX S MCommission No. ''4"oFtid° EXF(SM4 May 19,2018
(407)39"163 Florldallota (407)39s-0153 FlorldallotaryService.com
Revised 07/15/2014
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DATE
COMPLETE
INITIALS
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