HomeMy WebLinkAboutBuilding Permit ApplicationINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
08/1&2017 Permit Number.
ME Fill
Building Permit Application
g and Development Services
FAPPLICAPLICABLE
and Code Regulation Division
irginia Avenue, Fort Pierce FL 34982
:(772)462-1553 Fax:(772)462-1578 Commercial Residentialx
IT APPLICATION FOR: Plumbingu
lSED
IMPROVEMENT LOCATION::
10104 Crosby Place. Port Saint Lucie, FL 34986
scription: POD 26 At The Reserve
Property Tax ID q: 3327-709-0018-000-8
Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIONOF WORK:
50 Gal ELEC Water HEater Replacement
CONSTRUCTION INFORMATION:
�l�iujjona wor o 1e�r ni: un ert is Tan mit—c I a appy:
I�e
I]Gas Tank Das Piping El Windows/Doors
lLI(HVAC
LI�_IIShutters
I
LlElectric 21PlumbingSprinklers 0Generator El Roof Roof pitch
Total Sq. Ft of Construction: 5 Ft. of First Floor:
Cost of Construction:$ 1250 Utilities:0Sewer USeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Robert Madden
Name: Dim Bobev
Address: 10104 Crosby PI
Company: Fbnda Delta Mechanical
P Y:
City: Pon Saint Lucie State:F�
Address: 2716 Broadway Center Blvd
Zip Code: 34989 Fax:
Brandon
City: State: FL
Phone No. 772-464-0764
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.cam
from the Owner listed above)
State or County License: CFC1425917
If value of construction is $2500 or more, a —RECORDED of Commencement 11 required.
CONSTRUCTION LIEN LAW INFORMATION:
INEER:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_Not Applicable
rSUPPLEMENTALAL
v
Address:State:
Signature of Contractor
Phone
_
City:
Zip: PhoneLE
State:
HOLDER:
_ Not Applicable
BONDING COMPANY:_Not
Name:
Applicable
Address:
20� by
Address:
� by
City:
i Mj-4
'''1
City:
Name of P!raking making statement
Personally Known _ OR
Zip: Phone:
W omen r ....,r....�....
Produced Identification _
Zip: Phone:
OR Produced Identification
...., .:n] W1.I RACI OR AFFM l I : 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. is in conflict with ani( applicable (Home Owners Association rules authorize
bylaws or anScovenants 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,
accessorystructures, 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;/ou intend to obtain financing, consult with lender or an attorney before
commencine we& nr ro,+, fo, ..ki-,;� .,c
v
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor
ce a Holder
STATE OF FLORI �+1^ _
STATE OF FLORI
COUNTYOIP _ 1 UC�r CJ.A(
COUNTYCI 11��('
'—
A(^� �j' y,
The Ing instr ent was acknowledge before me
thi day of
The oing instrp)gent was acknowledged before me
20� by
th)
� by
I 2
i Mj-4
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�
Name of P!raking making statement
Personally Known _ OR
Name of pe n making statement
�
Produced Identification _
Personally Known
OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Produced
y
�AYMIII lrr1
(Signature of Notary Public- State o to a)
) A MA/yi /n n
(Signature of Notary Public- State of FI ida )
Commission No. "i+q"i•!'y_ SHNINNION E. BYRNE
Commission No.3trt`.
,v r�t�N NON E. BYRNE
MYOOMMISSKk1MGG1S2i5]
..: MYi`.W51@ISSIONYGG 1314
is FJ(PIRES: hugust 7, 2027
'er EXPIRES: August 7, 2021
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'' Ibr4etl mN Norex PWtic
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION
SEATURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW
REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
:ev. A/7/17