HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
� J
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 3189 LINDA VISTA AVE FORT PIERCE, FL 34982
Legal Description: MARAVILLA HTS BLK C
Property Tax ID ff: 242860101440006
Site Plan Name: ANGIE TOMLINSON
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I III
I40GAL ELEC WATER HEATER REPLACEMENT
CONSTRUCTION INFORMATION: I III
__JHVAC LJ Gas Tank
11 Electric R1 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1264
Piping IIL�J Shutters
nklers LI Generator
_ SFt. of First Floor:
Utilities:t Sewer Oseptic
❑ Windows/Doors
Roof = Roof pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Nam a CENTER FOR SPECIAL NEEDS TRUST ADMIN INC
Name: DIMITREBOBEV
Address: 4812 CREEKSIDE DR
Company: FLORIDA DELTA MECHANICAL
City: CLEARWATER State: FL
Zip Code: 33760 Fax:
Phone No. 772-812-6480
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 required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
r
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
COUNTY OF
Address:
The forgoing instru nt was acknowledged before me
City:
Zip: Phone
State: _
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
r uced
Address:
nature of N a blit- to of FI da
City:
Commission Na I� µw4 OMMISSIbbN#F12g112
�' ASHLEY NICOLfyfM1ENGEIST
City:
' y
EXPFFES May 7, 2018
Zip: Phone:
FRONT
Zip: Phone:
SUPERVISOR
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 Countyy makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in contlict with any applicable Home Owners Association rules, bylaws or ancovenantsthat may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
Inconsideration 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
comm . ng worlit or regarding Your Notice of Commencem
r
r
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Halder
STATE OF FLORID II II <<
�4V
STATE OF FLORIDA I If I c
�JlLL
COUNTY OF
COUNTY OF
The forgoing instr ntwa acknowledged before me
The forgoing instru nt was acknowledged before me
hl day 2ga by
FlyD2✓inli�2
t I5 day f 20 by
Name of pers aking statement
Personally Known �OR Produced Identification
Name of perso making statement
Personally Known � OR Produced Identification
Type of Identification
T e of Identification
oduced
r uced
ignaturp o Nq>W y u ¢- e o
nature of N a blit- to of FI da
t p r,_ASHLEYI OLE ZIE JGEIST
Commiss N T MY COMMISSION#40fillibla
EXPIRES May 7, 2018
Commission Na I� µw4 OMMISSIbbN#F12g112
�' ASHLEY NICOLfyfM1ENGEIST
n;
f ase.oiv flgryaallo�ary$ervlcp.com
' y
EXPFFES May 7, 2018
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17