HomeMy WebLinkAboutBuilding Permit Application Nov 0316 01:14p CRS Plumbing 772-460-7774 p.2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: u (, , Permit Number
Building Permit Application NOV l
Planning and Development Services G �O
Building and Code Regulation Division PEP,1AITTli�G
2300 Virginia Avenue,Fort Pierce Ft 34982 St. Lucie County, FL
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential xxx
PERMIT APPLICATION FOR: Plumbing wfyvex
PROPOSED IMPROVEMENT LOCATION:
Address: 11685 Twin Creeks Dr
Legal Description: TWIN CREEKS I THAT PART OF LOT I5MPDAr:MOM SE COR SO LOT 15 RUN NE.LYALG ELY U OF SD LOT 130.14 FT TO POB,TH COM ON ELY AND NLY LI OF SO LOT 15
56594 Fr TO NW CGR SD LOT 15,TH SWLY ALG WAY u SD LOT'260.68 FT,TH S 77 DEG 06 IAN 5a SEC E 174 FT.TH N 12 DEG 51 MIN o2 SEC E 26 5a FT,TH S 74 DEG 14 UIN 25 SEG E365.49 FT TO POB(1.93 AC)(OR 3919-220 1
Property Tax ID M. 2333-601-0015-010-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
[DETAILED DESCRIPTION OF WORK:
Replace exisfing 50 gal elec HWH
CONSTRUCTION INFORMATION:
itiona wor to e e orme un ert ispermit—checka appy:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ❑Plumbing ]Sprinklers Generator Roof
Total Sq.Ft of Construction: SFt.of First Floor:
Cast of Construction:$ 786 Utilities Sewer E]Septic Building height:
OWNER/LESSEE: CONTRACTOR:
Name Reuben Carlton Name: Reed Sudderth
Address:11685 Twin Creeks Dr Company: CRS Plumbing
City: Fort Pierce State:FL Address: P.O.Box 12755
Zip Code: 34945 Fax: City: Fort Pierce State:FL
Phone No.772-216-4881 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.
Nov 0316 01:14p CRS Plumbing 772-460-7774 p.3
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 con list 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 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 lender or an attorney before
commencing work or recording our Notice of Commencement.
L�14eev 104 S
_Signature of Owner LesseelAgent Signature of Contra r/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF s,L.ae COUNTY OF 5«ucs.
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this-day of ItQ , 20 !—by, this 3 clay of tI ,20 (1 by
Edward D.Jendu#- Edward D.Jendon
(Name of person acknowledging) (Name of person acknowledging)
( ignature of Notary P I' -State of Florida) ( ' natu e of Rotaix Pljhoq�State of Florida
Personally Kno r��!"'--'.`�. � �Bd�1�i@1�t�1 Personaln �WggieT1�c tion
Type of Identifi fstib rpQ Type of 1 is ro uce
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a, f EXPIRES Ma�!'19,2018 .e1 FlorldaNatary5erVice.
Commission N Not-A 1.com Commiss
Revised 07/1512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS