HomeMy WebLinkAboutbuilding permitALL 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
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Plumbing
Pit300Sp E1JI?UEIENT�OCAQN
Address: 511Q `�jrrc� Dr
Legal Description: INDIAN RIVER ESTATES -UNIT -08- ELK 69 LOT 1 (MAP 34/11S) (OR 4045-1504)
Property Tax ID #: 3402-609-0607-000-7 Lot No.1
Site Plan Name: Block No. 69
Project Name: ROGER BRIGGS
Setbacks Front Back: Right Side: Left Side:
40 GALLON WATER HEATER REPLACEMENT.
HVAC Gas Tank E]Gas Piping
Electric Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 1139.28
Shutters Windows/Doors
Generator Roof = Roof pitch
5 Ft. of First Floor: _
Utilities: Sewer E]Septic
Building Height:
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CONTRACTt3�` ale tjvlgebanctal
Name ROGER BRIGGS
Name: Dimitre Bobev
Address: 5904 Birch or
Company: Florida Delat Mechancial
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No.
Address: 2716 Broadway Center Blvd
City: Brandon State:fl
Zip Code: 33510 Fax:
Phone No. 866-279-0880
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.
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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 Countyy 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
commencing work or recording your Notice of Commencement.,-,
Rev. 8/2/17
i
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signatu4 of Contracto /License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF r O
The forgoing instrument was acknowledged before me
The orgoin instrumentg� was acknowledgbefore me
-this da v 20—by—
-th' - - da -of{ ---�=i , 2G-� by ---
-Name
Name of person making statement
Name of pe making statement
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Personally Known OR Produced Identification
Personally Kn=w OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- SIa
,- "�'yv r,'y •., SHANNON E. BYR
f3o�'C7
Commission No. (Seal)
Commission NO�C7 _N;($dWOMMISSION#GG
;>;r� E%PIRES:August7,2
9onded Thai Notary public Una
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17