HomeMy WebLinkAboutBuilding Permit Application Jul 21 1611:21a CRS Plumbing 772-460-7774 p.2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:1`TT`� _ �t~ ��,�D .?U� � 1 ����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 %0(XXx
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 4001 MiIGsa Ter
Legal Description: HARTMAN HEIGHTS UNIT 1 LOT 1 (1.00 AC)(OR 3421-1872)
Property Tax ID#: 2417-602-0001-000-1 Lost No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Correct existing lift pump to meet code.
CONSTRUCTION INFORMATION:
Additional work toe e rine under is permit--checka appy:
HVAC 0Gas Tank Gas Piping _Shutters Q Windows/Coors
LlElectric W-Plumbing Sprinklers Q Generator U Roof
Total Sq.Ft of Construction: So-Ft.of First Floor:
Cost of Construction:$ 2027.00 Utilities: Sewer Septic Building Height.
OWNERAESSEE: CONTRACTOR:
Name Melody Mae Ludwig Bly Name: Read 5uddar:h
Address:4001 Millisa Ter Company: CRS Plumbing
City: Fort Pierce State:FL Address: P.O. Box 12755
Zip Code: 34947 Fax City: Fort P°erre State:FL
Phone No.772-871-7516 Zip Code: 34979 Fax: 772-460-7774
E-Mail: Phone No. 772-466-7763
Fill in fee simplelitle 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 Ls re,paired.
Jul 21 1611:21a CRS Plumbing 772-460-7774 p.3
SUPPLEMENTAL CONSTRUCTION LIEN LAW fNFORMATION-
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 BOUNDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Countv 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 Horne Owners Association rules,bylaws or andcovenantsthat 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 lander or an attorney before
commencing work orrecordir!g your Notice of Commencement.
S
_Sig re of Owner/Lessee/Agent Signa of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF&LUCle COUNTY OF SIL-.
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 21 day of JtA_ , 2D Lby this: day of JUG .20 /by
Edward D.Jendrnt- Edward D.Jendare
(Name o rson ackno ging) (Name of person acMdglng
(Sig ature of Notary Public- to of Florida) (Siliciature of Notary PuVic-S to of Florida)
' r � �fPersonally Known 3JAPersonally Known
��ti• ttIB6
Type of Identiftcatiotb Type of Identification q�qu
EXPIR S y�a1
Commission No. '� �6,' EXP(R%May 19,2018 y9,2p18
Commission No. �` """" all
(407)39153 FbridallottayServkxsom 63 Fbri of Servme.corn
Revised 07115/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS