HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
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
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: Af/UYl Js)^ .if (\)l'/'^h NUfOlnnWL XxJanri C/TYJnPfliniUIlfl
(ir 72M-iric) {}nif PHI- cor zi^i--/^i7^
Property Tax ID #: / V23 - ? - 00*-) (p - OOQ - 5
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side:
Lot No.p^ J-
Block No.
Left Side:
DETAILED DESCRIPTION OF WORK:
iepkcc ^0 Gc^\-ier HeciAet lOi-^ Ri^ 50 (k\^
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all
Gas Tank jGas Piping
hat apply:
Shutters
Generator
LJHVAC
Electric ^Plumbing I I Sprinklers I _
Windows/Doors
Roof
Total Sq. Ft of Construction:
Cost of Construction: S B O • Q/O
Sq
Utilities;
. Ft. of First Floor
Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name "^(TA C^lHer
Address: ^10?. fO f)\Pl ODK # PH X
Name: CRAIG MOBLEY
City: fhr-^ p)?y(V . State: f L
Zip Code: 3Wd. Fax:
Company: SOUTHERN PLUMBING, INC
Address: 4069 43RD AVENUE
City: VERO BEACH
Phone No. ^07-(g9V- 9J>)7-
E-Maii:J^M
Zip Code: 32960
State:
Fax: 772-978-9843
Phone No. 772-564-6980
Fill in fee simple Title Holder on next page (if different
from the Owner listed above) i
E.Maii: S0UTHERNPLUMBING@A0L.COM
State or County License: RF0067100
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip:
Not Applicable
State:
Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip:
^ Not Applicable
Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
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 ail 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 rjKJst be recorded and posted on the jobsite
before/hjTfirst inspection. If you intend to obtain financing, c/iryfiuW. with lender or an attorney before comryfen^ng work or Recording your Notice of Commencer
ner/ Le^ee/Agent
STATE OF FLORIDA
COUNTY OF JNDIAN RIVER
The for|oing instrument was acknowledged before me
this _L2 day of Jl^'Y , 20 i u by
(Name of person acknowledgirig.
(Signature of Notary Public- State of Florida
Personally Known. OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
KtMBERLY MAY
I MY COMMISSION «>FF24100i
EXPIRES June 18.2019
(407)39»0'S3 FtendjNoM>Y8«'vicB.con'
iontractqf/License Holder
OF FLORIDA COUNTY OF iNPiAN RIVER
The forgoing instrument was acknowledged before me
this ifL day of TU i ^ 20 [ilL by
(Name of person'acknowledglng
(Signature of Notary Public- State of Florida ;
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. rf^^i-bh^- (Seal)
KiMBERLY MAY
•1 MV COMMISSION 0FF241B65
EXPIRES June 13,2019
REVIEWS
"DATE
COMPLETE
INITIALS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW