HomeMy WebLinkAbout4614_001ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: I; 9/aFAT 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
PERMIT APPLICATION FOR: Plumbing
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[]Gas Piping
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P,ROPOSE3(PIOVC11t1EfLOCATION........,.
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Address: 4201 Sunrise Blvd
Legal Description: 33 35 40 FROM NW COR
Property Tax ID #: 2433-413-0001-000-1
Site Plan Name: James Pounds
Project Name: James Pounds
Setbacks Front Back:
50 GALLON HOT WATER HEATER
Right Side: Left Side:
Lot No.
Block No.
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HVAC 0 Gas Tank
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[]Gas Piping
apply:
Shutters
F—] Windows/Doors
Electric
Z Plumbing
Sprinklers
_
11 Generator
E]Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1202.00
SFt. of First Floor:
Utilities:cnSewer Septic
Building Height:
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NameJames Pounds
Name: Dimitre Bobev
Address: 4201 Sunrise Blvd
Company: Florida Delta Mechanical
City: Saint Lucie County State: FL
Zip Code: 34982 Fax:
Phone No.772-216-4971
Address: 2716 Broadway center Blvd
City: Brandon
Zip Code: 33510 Fax:
Phone No. 866-219-0880
State:FL
866-219-0729
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:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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FORMATIQ T4 :,
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address: 4201 Sunrise Blvd
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
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
commencine work or recordin¢ vour Notice of Commencement.
Rev. 8/2/17
Si nature of Ow ee/Contractor as Agent for Owner
SYgnature of Co /License Holder
STATE OF FLORID11
STATE OF FLORIDA I I S
COUNTY OF �IY�S
COUNTY OF L L
Tfo going instr e t as acknowled a before me
The fo 'ng instrum s cknowled,�ge/d before me
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Name of person making statement
Name of person making statement
Personally Known' OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
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(Signature of o ary Publi State of orida)(Signature
of Iary Pu l I IAfj@EY NICOLE ZIEGENGEI'
Commission No•":>?.::.P.p`''-.. SkILEYNICOd§g48GENGEIST
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(a0l)39&8153 FloritlallotarySemce.com
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(407)399.01 63
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Rev. 8/2/17