HomeMy WebLinkAboutBuilding Permit ApplicationALL 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
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: 1772)462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT
LOCATION:
Addre55: 4045 GREENWOOD DR FORT PIERCE, FL 34982
Legal Description: GREENWOOD BLK 2 LOT 15
Property Tax ID #: 2421-702-0048-000-2 Lot No.
Site Plan Name: Block No.
Project Name: W. BRITTON
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
40 GAL ELEC WATER HEATER REPLACMENT
CONSTRUCTION INFORMATION:
Itlona war o un ert Is permit—Checka appy:
nrTormed
❑ _HVAC Gas Tank E]Gas Piping ❑Windows/Doors
_Shutters
Electric Plumbing 05prinders Generator Roof Roofpitch
Total Sq. Ft of Construction: SCLFt. of First Floor:
Cost of Construction:$ 1237 Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name WILLIAM BRITTON
Name: DIMITRE BOBEV
Address: 4045 GREENWOOD DR
Company: FLORIDA DELTA MECHANICAL
City: FORT PIERCE State:FL
Address: 2716 BROADWAY CENTER BLVD
Zip Code: 34982 Fax:
City: BRANDON State: FL
Phone N0.772-579-1044
Zip Code: 33510 Fax: 866-219-0729
E -Mail:
Phone No. 866-219-0880
Fill in fee simple Title Holder on next page ( if different
E -Mail: FLPERMITS@DELTAMECHANICAL.COM
State or County License: CFC1425917
from the Owner listed above)
N value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
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:
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
improvements to your property. Notice of Commencement must be recorded and posted on
before the first ins coon. �ylntend to obtain financing, consult wo lender, orAh attorney
argnanre ar uwner/ Lessee/contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA I STATE OF FLORID
COUNTY OF ``, COUNTY OF
j I�
Theoing ins n s knowledg efore me
this day of�, 2GEby
[11m'+fc Abey
Name of persprnaking statement
Personally Known Y OR Produced Identification _
Type of Identification
Theigrgen oing lnstr acknowledge efore me
this ''w1l day of,20by
N(Mijle 6IDMI/
Name of pe son making statement
Personally Known X OR Produced Identification.
Type of Identification
(Signature of Notary Public- State of Floriba I (Signature of Ni
Commission No.'.`+, SHfggglp E. BYRNE Commission No.
IAY MISSION
%GG 132457
9 RPIRES:August7,2021
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