HomeMy WebLinkAboutscan0305ALL 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 x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 1712 Paseo Ave, Fon Pierce FL 34982
Legal Description: MARAVILLA PLAZA BLK 11 W 30 FT OF LOT 16 AND E 35 FT OF LOT 17 (0.19 AC) (OR 447-2109)
Property Tax ID #.. 2421-802-0148-000-0 1I
Lot No.
Site Plan Name: Block No. 11
Project Name: SUSAN BREWER
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
40 Gallon Electric Water Heater Replacement
CONSTRUCTION INFORMATION:
Additional wor oIe 1eI Orme un ert is permit — c ec a appy:
❑HVAC nGas Tank ❑Gas Piping _Shutters Windows/Doors
OElectric OPlumbing
❑Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 1,210.82 Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Susan Brewer
Name: 0imioe aobev
Address:1712 Passaic, Ave
Company: Honda Delta Mechanical
p y
Fort Pi
City: State:FL
Address: 2716 Broadway Center Blvd
Zip Code: 34982 Fax:
City: Brandon State:FI
Phone No. 772-466-3379
Zip Code: 33510 Fax: 866-219-0729
E -Mail:
Phone No. 866-219-0880
Fill in fee simple Title Holder on next page ( if different
E -Mail: flpermits@deltamechanical.com
from the Owner listed above)
State or County License: CFC1425917
If value of construction is $3500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
FRONT
COUNTER
ZONING
DESIGNER/ENGINEER: _ Not Applicable
PLANS
MORTGAGE COMPANY:
x Not Applicable
MANGROVE
Name:
Name:
REVIEW
REVIEW
Address:
REVIEW
Address:
DATE
City: State:_
City:
State:
COMPLETE
Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY:
x 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.
Inconsideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work r
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 WNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvem nts o your prope Notice of Commencement must e r orded and posted on the jobsite
before th ,fir inspection. I ^ou^ntend to obtain financing, consultwit lender or an attorney before
commen ne ork nr rorr,r nL.«,,.., ..«,.....�_______�
as
COUNTY OF STATEdFFLORI DA �\iL
The _ oing instrument WW, ��ckrrllowledged before me
this ay of 20 by
STATE OA FLORIDA. 1 j ��1 C
COUNTY OFy�l--'1
The fpipoing instrurnent was acknowledged before me
this �(jRay of._, ZO Ll by
person
V
Personally Known OR Produced Identification _ Personally Known OR Produced Identification
Type of Identification Produced Type of Identificatio Produced
Commission No. <; ASHLEY NIPM)ZIEGENGEIST Commission No. HLEYN111604IEGENGEIST
MY COMMISSION #FF120712
MY COMMISSION #FF12n]i2
REVIEWS
FRONT
COUNTER
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS