HomeMy WebLinkAboutBuilding Permit Application 2019-03-22 11:09 AM (EDT) To: +1 772-462-1578 From: +1 866-219-0729 Page 1/2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -1"
Date: 5-C` ?Ca-
_t,"9 Permit Number: t" f( '06�uj
_Vse?lozEimPtwE z_ RECEI
��D
Y,
CCIelNT "
Building Permit Applicatio MAR 22 2018
Planning and Development Services Sr, Lucie
Building and Code Regulation Division �;6,yf1 ,r II
2.300 Virginia Avenue,Fort Pierce FL 34982For, y
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION Y
Address: 7102 PENNY LANE
Legal Description: LAKEWOOD PARK-UNIT 9 II
Property Tax ID ft: 1301-611-0184-000-6 Lot No.6
Site Nan Name: Block No. 109 !i
' Project Name: APPLEBEE
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK *v r w ': ` -
45 GAL ELEC WATER HEATER REPLACEMENT
CONSTRUtCTION INFORMATION i
G ® Z Y 5 S ..a. I-.-.:.
Additional work to be�erformd u
ender this permit—check ail tha apply:
nHVAC Gas Tank Gas Piping I Shutters Li Windows/Doors I,
Electric V PlumbingSprinkiers III Generator 0 Roof Roof pitch
1
Total Sq. Ft of Construction: STA of First Floor:
Cost of Construction:$ 895 Utilities:I'Sewer 0 Septic Building Height:
a '------:- ' '`OWNRLSSES V 4CORATOR,
Name CARLTON APPLEBEE JR.,LYNDA F APPLEBEE Name: DIMITRE BOBEV
Address:7102 Company: FLORIDA DELTA MECHANICAL
City: FORT PIERCE State:FL Address: 8402 LAUREL FAIR CIR SUITE 111
Zip Code: 34951 I Fax: City: TAMPA State:FL l
Phone No.772-465-6972 - Zip Code: 33610 Fax: 866-219-0729
E-Mail: I 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.
2019-03-22 11:09 AM (EDT) To: +1 772-462-1578 From: +1 866-219-0729 Page 2/2
t/ /
St-DR MINI MTAL O S 114 MON EN LAU1ON FORMATION
DESIGNER/ENGINEER: *Not Applicable MORTGAGE COMPANY: —Not Applicable
Name: Name:
Address: Address:
Cit N: State: City: State:
Zip: Phone Zip: Phone:
FEESIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _,,,_Not Applicable
Na me: Name: ii
Ad dress: Address: li
City City: '
zip: Phone: Zip: Phone: I
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. Lu de 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 twice for I
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite il
before the f' inspec on. If ou intend to •btain financing,consult ' h iender,or an ttorney befor
commend rl_ orkor •cor gyo Noti'- of Commencement.
Signature of Owner!Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
I
STATE OF STATECOUNTY OFO RIDA<tISbchrcih UNTYOFFORIDrtfliS10v h
The forgoing instrument was acknowledged before me The forggoing instrument was acknowledged before me
this. 7,day of Y"YIO Yal ,20 VI by this `it day of y}V,vc1r1 ,20 ll by
OtWli'1YC, 6066 btyr,r 63 bou ,
Name of person making statement Name of person making statement
Personally Known / OR Produced Identification Personally Known / OR Produced Identification
Type of Identification Type of identification it
Produced Produced 11
/ /4,--- ..Cifr_A-- .(1,1-7-42/1-2,._ ,
1-7-42/1-2,. Lyle-d y ist_
: ; _ {Signator of N ry R :, - ==_C .. t
{Signature of Not ry Pu•_ -�:,-` f;^ ILY H.MEDItiA G s d ,� '
7� `�`ll • :i�r�roV '' 274bS Sit),*t*i , r EMILYH.M6DINA
Commission No. `—`` :t' t1 2422 ommission No. _.: ,!� g4; PdYCOM froll#GG 227058
.9: .S:dune t .d r,„'..:4'f: EXPIR S:Juneli.2022 `
.4..r.,i P;• IcUnderviters 'OrFo, o@.�
•.�"cF f;R•' Boded Thru Notary Pubs Bonded lhru Notary Puts% miters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED I
DATE i
COMPLETED
Rev.8/2/17
t
i