HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i Permit Number:
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J 16
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34987
Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 9650 S OCEAN DR UNIT 1209. HUTCHINSON BEACH, FL 34957
Legal Description: THE PRINCESS OF HUTCHINSON ISLAND
Property Tax ID H: 4502610-0119-000-3 Lot No.
Site Plan Name: WATER HEATER REPLACEMENT Block No.
Project Name: RODMAN GOODWIN
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
30 GALLON ELECTRIC WATER HEATER REPLACEMENT
CONSTRUCTION INFORMATION:
AU01nional worK to be erJormed un ert is permit—c ec a appy:
❑�IIHVAC Gas Tank ❑Gas Piping Shutters ❑ Windows/Doors
Il��_ll
11 Electric Plumbing Sprinklers L lGenerator Roof Roof pitch
Total Sq. Ft of Construction: 5 Ft. of First Floor:
Cost of Construction:$ 1106 Utilities:[]Sewer Septic Building Height:
/LESSEE:
CONTRACTOR:
MAN GOODWIN
Name: DIMITREBOBEV
650 S OCEAN DR UNIT 1209
Company: FL DELTA MECHANICAL
rHUTCHINSON
HINSON BEACH State:FL
Address: 2716 BROADWAY CENTER
34957 Fax:
City. BRANDON State:FL.312-485-2412
Zip Code: 33510 Fax: 866-219-0729
Phone No. 866-219-0880
neesimple 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 $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: RoonIAN L000ww
MORTGAGE COMPANY:
NJame: olmlrRE Boeav
Not Applicable
AdUrE$$:885050LEAN OR UNIT 1888. HVTLHWSON BEACH. FL 3<8A
Address: 9550BOCEAN nR UNIT IRW
City: nuTCHINBON REACH S[d[e;
Zip: Phone
City: BRpNMN
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address: R]1fi eROAOWAY CENTER
Address:
City:
Gty:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 antl 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
r r rec m our o ce o ommenceme
comme wok d' N f CSTATE
r
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], 2018
Signatur of Owner essee ontractoras Agent for Owner
Signa[ oContr for Lid nse ler
FRONT
ZONING
OF
COUNTY OF ORIDAr 1111
STATE OF
COUNTY OFOR�11,1�
VEGETATION
The f oing instru nt was acknowledged before me
this�day of 20� by
The f ing instru nt was acknowledged before me
is day f���' 20y� by
COUNTER
REVIEW
t111�Y.
REVIEW
REVIEW
Name of person making statement
Personally Known - OR Produced Identification _
Type of Identification
Name of p rrsop making statement
Personally Known Jam— OR Produced Identification _
Type of Identification
DATE
induced
aduced
RECEIVED
(Signature of
•c,t w,. ASHLEY NICOL �rr;;ENGEIST
CommisslanN + n
MMI561 NxFFf 20712
EXPIRES May 7, 20tH
wn�'�
Signature oto ublic- to of rich)
Commission No a «`•, ASHLEY NIr���IEGENGEIST
gga Yee MMI SIGN #FFI2Wf2
EXPIRES may
DATE
COMPLETED
Rev. 8/2/17
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: RoonIAN L000ww
MORTGAGE COMPANY:
NJame: olmlrRE Boeav
Not Applicable
AdUrE$$:885050LEAN OR UNIT 1888. HVTLHWSON BEACH. FL 3<8A
Address: 9550BOCEAN nR UNIT IRW
City: nuTCHINBON REACH S[d[e;
Zip: Phone
City: BRpNMN
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address: R]1fi eROAOWAY CENTER
Address:
City:
Gty:
Zip: Phone:
Zip: Phone:
], 2018
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
MANGROVE
SEA TURTLE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED