HomeMy WebLinkAboutBuilding Permit Application Dec 2916 01:52p CRS Plumbing 772-460-7774 p.2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _ 141 Permit Number.
Building Permit Application RECERVED
planning and Development Services DEC 2 9 2016
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential xxxxx
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 6105 Raintree Td
Legal Description: INDIAN RIVER ESTATES-UNIT-09-BLK 71 LOT 34(MAP 34/11S)(OR 3614-2480)
Property Tax lD#: 3402-610-0056-000 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Connect new city meter to house tie in.
CONSTRUCTION INFORMATION:
Acid itional worK to De performed un er this permit—c ec all apply-,
QHVAC L_I Gas Tank ❑Gas Piping Shutters a Windows/Doors
Electric ❑Plumbing Sprinklers E]Generator Roof
Total Sq.Ft of Construction: S _Ft.of First Floor:
Cost of Construction:$ 380.00 Utilities:CnSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name US Bank NA Name: Reed Sudderth
Address:4801 Frederica St Company: CRS Plumbing
City: Owensboro State: Address: P.O.Box 12755
Zip Code: 42301 Fax: City_ Fort Pierce State:FL
Phone No.586-772-7600 Zip Code: 34979 Fax: 772-460-7774
E-Mail: Phone No. 772466-7763
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-
Dec 2916 01;52p 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 TITLEHOLDER: _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 thepermit holderto 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 1 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 exemptfrom 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.
A;� S
Slggakre of Owner/Lessee/Agent Sign re of Contractor License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SiwQe COUNTY OF st—
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_Z? day of DEC , 20 L-1- by this o?Q day of VEC ,20 &__by
Edward D,Jerndorl` Edward 0.Jendan
(Name of person acknowledging) (Name of person acknowledging)
� .
(Signature of Notary Public to of Florida) (Signature of Notary Publ State of Florida)
Personally Known ro �WAH i ati Personally Known .. ux20
Type of Identification n`� D .•77 Type of Identification r t ` n EDWARD D JENDON
ii
My COMMISSION#�FF124587
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Commission No. !c;�Rd EXPIi IpAay 19,2018 Commission No. k:h, EXPIR�RI�ry 19,2918
(407)39a-0153 FIMdallotarySenrice.COm (407),W"153 Flaridallot"Semice.com
Revised 07/15/2014
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