HomeMy WebLinkAboutAPP SLCALL 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: Plumbing 0
PROPOSED IMPROVEMENT LOCATION:
Address: 3004 ANDERSON DRIVE FORT
Legal Description: SHERATON PLAZA
Property Tax ID #: 1432-807-0004000-5
Site Plan Name: M. BENNETT
Project Name: M. BENNE7T
Setbacks Front Back:_
FL 34947
Right Side: Left Side:
Lot No. 246
Block No.
DETAILED DESCRIPTION OF WORK: III
150 GALLON GAS WATER HEATER REPLACEMENT
I CONSTRUCTION INFORMATION: III
JHVAC LJ Gas Tank
11 Electric 21 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1358
Piping
!rs LJ Generator
SqI FFtt.I of First Floor: _
Utilities :I�ISewer DSeptIc
❑Windows/Doors
11 Roof = Roof pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name MARGARETTE BENNETT
Name: DIMITREBOBEV
Address: 3004 ANDERSON DRIVE
Company: FL DELTA MECHANICAL
City: FORT PIERCE State:FL
Zip Code: 34947 Fax:
Phone No. 772-359-0276
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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is require,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
OF ORI
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
,.,,..:7
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 con�lict with any applicable Home Owners Association rules, bylaws or an covenants that may restrict of 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
rnmmpnrina work Ar remrdinoumir Notice of Commencement.
Rev, 8/2/17
Signature of Contract r/1-cens i er
Signature of Owner/ LLe�ssee/ ntractor as Agent for Owner
OF ORI
STATE OF ORIDA I I'
COUNTY OFSTATE
ill I Is
COUNTY OF I
The f r Ding instrument w s acknowledged before me
by
The fryq'���ing instr ent w acknowledged before me
this:/ dayof 20_L by
this of 20.0
L�Libe�
1
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Name of pe n making statement
Name of pe n making statementl�;;v,,,
Personally Known OR Produced Identificati`°:°W;`.+
Personally Known A OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
I
F% -
air
(Signature of Notary Public- State of Flo r a)
r
(Signature of Notary Public -State of FI 'da)
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Commission No. (Seal)
Commission No. (Seal)
REVIEWS FRONT ZONING
SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW
REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev, 8/2/17