HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: s � 0,, 111 Permit Numb
.200010_
1. .. J._ ..__.
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 172 NE LOBSTER RD PORT SAINT LUCIE, FL 34983
Legal Description: RIVER PARK
Property Tax ID #: 3419-560-0014-000-7
Site Plan Name: WATER HEATER REPLACEMENT
Project Name: KEN ISSA HOWELL
Setbacks Front Back: Right Side:
Left Side:
Lot No. 14
Block No. 73
DETAILED DESCRIPTION OF WORK: III
140 GALLON ELECTRIC WATER HEATER REPLACEMENT
CONSTRUCTION INFORMATION: III
L_J Gas Tank LJGas Piping ILJ Shutters
21 Plumbing Sprinklers L- JGenerat(
Total Sq. Ft of Construction:
Cost of Construction: $ 1366
SqI FFtt.� of First Floor:_
Utilities: L,� Sewer OSeptic
❑Windows/Doors
11 Roof = Roof pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name KENISSA HOWELL
Name: DIMITREBOBEV
Address: 172 NE LOBSTER RD
Company: FL DELTA MECHANICAL
City: PORT SAINT LUCIE State:FIL
Zip Code: 34983 Fax:
Phone No.772-801-7954
Address: 2716 BROADWAY CENTER BLVD
City: BRANDON State:FL
Zip Code: 33510 Fax: 866-219-0729
Phone No. 866-219-0880
E -Mail:
Fill In fee simple Title Holder on next page ( If different
from the Owner listed above)
E -Mail: FLPERMITS@DELTAMECHANICAL.COM
State or County License: CFC1425917
It value of construction is 5<auu or more, a acr.enuce Henle u- ..eee... "I ....... . —1— ...
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:«ETIs MOWELL
MORTGAGE COMPANY:
Na me: OIMnRE BOBEV
_ Not Applicable
Address: 172 NE LOBSTER RD PORT SAINT LUCIE, FL3403
Address: lBNELOBSTERRO
City, PORTMINTLOCIE State: _
Zip: Phone
City: BRANDON
Zip: Phone:
State: _
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address: V16 BUCvU YCENTER BLVD
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 Count makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an 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
Signature•tif Owner/CRssee/Cbntrattor as Agent for Owner Signature or•contractor/alcensenolow
STATE OF FLORIDA 1. S•111C COUNTY OF STATECIFFLORIDA 111 C
COUNTY OF ..J lJ
The Ding instrum t was acknowledge efore me
this day of 20-W by
�tmt�r9- (440C,✓
Name of person making statement
Personally Known 14 OR Produced Identification
Type of Identification
Commission No.
!° `A:°`z : ASHLEY N%,L;� EGENGEIST
IF COMMI SIO #FF1207t2
`s;yo, wad' EXPIRES May 7, 2018
The f Ding rostrum t was acknowledg efore me
this day of 201 by
�t r)liw �y
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Commission
REVIEWS I CO NTER REVIEW SUPERVISOR
R I RE PLANS EW I REVIEW ON
My COMMiMi!)N #FF120712
EXPIRES May 7, 2018
SEATURTLE I MANGROVE
REVIEW REVIEW