HomeMy WebLinkAboutBUILDING PERMIT (2) ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Daat`e:f Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(7 7 21 462-157 9 Commercial Residential f
PERMITAPPLICATIONFOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 831 SE SOLAZ AVE
Legal Descriptiom RIVER PARK-UNIT 6-BLK 61 LOT 12(MAP 34128S)(OR 4021-2632)
Property Tax ID N: 341 BS45-0091-000-3 Lot No.12
Site Plan Name: Liu McBride Block No. 61
Project Name: Lisa McBride
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
40 GALLON HOT WATER HEATER f f vc +r,c
CONSTRUCTION INFORMATION:
Additional work to b r1ormed under this permit—check a app y:
�HVAC Gas Tank ❑Gas Piping _Shutters E]Wlndows/Doors
Electric Plumbing Sprinklers Generator Roof Roofpitch
Total Sq. Ft of Construction: Sc�rFtt.�of First Floor:
Cost of Construction:$ 1480.00 Utilities:Ll Sewer OSeptic Building Height:
llOWNER/LESSEE: - CONTRACTOR:FLORIDADELTA MECHANICAL
Name Name: DIMITRE 809EV
Address:631 5S Ave Company: FLORIDA DELTA MECHANICAL
City: Fi Sao4 lwc'e State:-F-1- Address: 2716 BROADWAY CENTER BLVD
Zip code:_NRSi'S Fax: d//sv.--c- City: BRANDON State:FL
Phone No. Su-53ri'OU31 Zip Code: 33510 Fax: 866-219-0729
E-Mall;lt;;' L Phone No. 866-219-0880
Fill In fee simple Title Holder on next page(if different E-Mail: 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: _Not 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 authorize thepermit holderto 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 concu rrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessary 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
cam in coo off creme your Notice of Commencement.
r r
Signatre of Owne/Lesse /Contractor as Agent for Owner Signature o ontractor icen'1sel1old
STATE OF FLORIDA 111 l STATE OF FLORIDA (ZOIIt5
COUNTY OF l COUNTY OF yV ll
The oing instrume was acknowledge f ppe�fore me The for ainginstrunrie� was acknowledge beforeme
this day of- ��20 `Nby thl day of- 1CC� d0 vby
1 111}v e 1'�c�82✓ M. r}v c Ua be,✓
Name of person yaking statement Name of Person making statement
Personally Known OR Produced Identification_ Personally Known OR Produced Identification_
Type of Identification Type of Identification
roduced P ced
ignature of N a , Ignature of Nqgry -
*'wA ...ASHLEY N�m'� I a °'4; AS FY N_ 1{f01E PEGENGEIS
Commission No. xxxxxx,,,,,arrr�� '''+`''' ��''''��"""" Isrurr ZIEGENGEIST Commission No. �z ! My c�3C1R�1fsSION*FFI2ml
Y COMMISSION NPFI2W 12
EXPIRES May 7.20l.To,M1dd_ EXPIRES
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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