HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLI ABLE INFO
�MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Residential x
�PROPOSEDIMPROVEMENTLOCATION: �I
Address: 9121 SHORT CHIP CIR PORT SAINT LUCIE, FL 34986
Legal Description: LAKES AT PGA VILLAGE
Property Tax ID #: 3334-501-0155-000.4 Lot No.
Site Plan Name: WATER HEATER REPLACEMENT Block No.
Project Name: CHERYL BARR
Setbacks Front Back Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
50 GALLON ELECTRIC WATER HEATER REPLACEMENT
❑HVAC
❑
Gas Tank
❑Gas Piping
Acidna,0121 SHORT CHIP CIR
❑_Shutters❑l
City: PORT SAINT LUCIE State: FL
Zip Code: 34986 Fax:
Phone No. 562-221-6622
Windows/Doors
Electric
OPlumbing
FIII in fee simple Title Holder on next page I If d'Ifferent
from the Owner listed above)
❑Sprinklers
State or County License: CFC1425917
11 Generator
❑Roof
=
Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 1195 Utilities: Sewer ❑Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameCHERYL BARR
Name: DIMITREBOBEV
Acidna,0121 SHORT CHIP CIR
Company: FL DELTA MECHANICAL
City: PORT SAINT LUCIE State: FL
Zip Code: 34986 Fax:
Phone No. 562-221-6622
Address: 2716 BROADWAY CENTER
City: BRANDON State:FL
Zip Code: 33510 Fax 866-219-0729
Phone No. 866-219-0880
E -Mail:
FIII in fee simple Title Holder on next page I If d'Ifferent
from the Owner listed above)
E -Mail: FLPERMITS@DELTAMECHANICAL.COM
State or County License: CFC1425917
n varus w mnevucui Is pow or more, a KCW KULU nonce or commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable
NaJme: cHERrL BARR
MORTGAGE COMPANY:
Name: DIRFRE SOBEv
Not Applicable
Address: 9121 SHORT CHIP CIS PORT SAINT LUCIE, F. 34ESE
Address. 9121BHORTOHIPCIR
City: PORT SANT LUCIE State:
Zip: Phone
City: BRANDON
Zip: Phone:
State: _
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address:27+6 BROPDwAr CENTER
Address:
City:
City:
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 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
STATE OF COUNTYOF ORID '`I I STATE OF FLORIDA, -III r
l COUNTY OF lJ
The forgoing instrum R was acknowledged before me
this day 1of20 by
�ttY'tT:_ CCbCV
Name of person making statement
Personally Known _� OR Produced Identification _
Type of Identification
The f oing inztrume was acknowledged before me
this rrdaylof� 20 ) by
Name of person making statement
Personally Known OR Produced Identification
Type of Identificatio
{s �.«•.. ASHLEY ry�CeeOaaIpIpE ZIEGENGEISTA-V•., ASHLEY NICOLE ZIEGENCEIST
Commission No. yCOrfMISSON #W12n212 Commission No. MYCOk`N0S*#FF12n)12
t 7lEXPIRES May 7, 2016 EXPIRES May ], 2018
�p Nm19Po#150 FlarrdRNataI,Serv¢e.COS
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
Rev.