HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Oeveiopment Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential V1
PERMIT APPLICATION FOR: Plumbing
PROPOSEDIMPROVEMENTLOCATION:
Address: 831 BE SOLAZ AVE
Legal Description: RIVER PARK-UNIT 6-BILK 61 LOT 12(MAP 3428S)(OR 4021-2532)
Property Tax ID#: 3419-545-0091-000-3 Lot No.12
Site Plan Name: Use McBride Block No. 61
Project Name: Use McBride
Setbacks Front Back: Right Side: Left Side.
DETAILED DESCRIPTION OF WORK:
40 GALLON HOT WATER HEATER
.CONSTRUCTION INFORMATION:
Additiona
wor to�ie erforme on erIris permit—c ec a apply
❑HVAC Gas Tank ❑Gas Piping (_Shutters Windows/Doors
Electric Plumbing Sprinklers ❑Generator L1 Roof Roof pitch
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1480.00 Utilities: Sewer Septic Building Height:
.OWNER/LESSEE: CONTRACTOR:FLORIDA DELTA MECHANICAL
Name Name: UNITIZE BOSEV
Address: Company: FLORIDA DELTA MECHANICAL
City: State:_ Address: 2716 BROADWAY CENTER BLVD
Zip Code: Fax: City: BRANDON State:FL
Phone No. Zip Code: 33510 Fax: 866-219-0729
E-Mail: Phone No. 856-219-0880
Fill in fee simple Title Holder on next page(if different E-Mall: FLPERMITS@DELTAMECHANICAL.COM
from the Owner listed above) State or County License: CFC1425917
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State:_ City: State:_
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Nat Applicable
Name: 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 autryorize the permit holder to build the subject structure
which isin conflict with any applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Homeowners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,1 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
cornm6king Work or regording your N tice of Commencement.
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Signat re of Owne /Lessee/Contractor as Agent for Owner Signature o Contractor icense old
STATE OF FLORIDA ( 'I1C STATEOF FLORIDA I'�S
COUNTY OF t 1 COUNTY OF
The( ing ins[rume was acknowledged pefore me The for oing instrume/st was acknowledged before me
this day_of JC \\2,0�nl Xby thi'g�y'�\g,day of 't G(p 20 1�y
�Ir.d6 667 L/ J�1(YLCtY� Uub6`/
Name of person paking 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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ignature of N a �y,�� Ignature of N ry -
A k'y ASHLEY N'SZIEGENGEISi Commission No. I * �'" AS 7q$N ZIEGENGEI
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Isovl aaec�aa FJ(PffiES May 7, 2018 w$w,n°°ef EXPIRES May 7, 201
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REVIEWS FRONT ZONING SUPERVI PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17