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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: dIIIIIII nN 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 PROPOSED IMPROVEMENT LOCATION: Address: 5833 MOSS CT 3E Legal Description: THE GROVE CONDOMINIUM -SECTION ONE- UNIT 3E (OR 4129-2181) Property Tax ID ##: 3410-507-0011-000-4 Site Plan Name: Project Name: Pruzinsky Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: 30 GAL ELEC WATER HEATER REPLACEMENT Lot No. Block No. CONSTRUCTION INFORMATION: Additional -work toe nertormed under this permit a che,all napply: HVAC Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors Electric 91 1 Plumbing ❑ Sprinklers 1:1 Generator Li Roof Roof pitch Total Sq. Ft of Construction: . Cost of Construction: $ 1389 5Ft. of First Floor: _ Utilities:'nSewer []Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Jane Pruzinsky Name: DIMITRE BOBEV Address: 5833 MOSS CT 3E Company: FLORIDA DELTA MECHANICAL Address: 8402 LAUREL FAIR CIR 111 City: FT PIERCE State: FL Zip Code: 34982 Fax: City: TAMPA State: FL Phone No. 973-420-6112 zip Code: 33610 Fax: 866-219-0729 -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) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION: DESIGNER/ENGVNEER: _ Not Applicable Name: MORTGAGE COMPANY: T Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable 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 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 beforee irst ins ectiorr� If you'inten o obtain financing, con with le der organ attorney b ore comm ci R work r rec{p,,{-din"our otice of Commencement�f j ( J 1"'! � q,(- Signature ,( Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF FIs Theforgoing instrument was acknowledged before me this 2 }'day of 0( , 20_0 by Name of person making statement Personally Known 0( OR Produced Identification Type of Identification rVJ'0_ (Signature of N am Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF _�—L/ Is The forgoing instrument was acknowledged before me tnis 2-5 day of oCt 20_rl by Name of person making statement Personally Known L--;�� OR Produced Identification Type of Identification Produced (Signature of DATE RECEIVED DATE COMPLETED Rev. 8/2/17 .=r ... • '�".. EMILY H. MEDINA Commission No. ,s MYCOMMISS ItpG22T456 Commission N "• MISSIONk%A7056 P83E5: Jane 11.2022.• . :a,' EXPIRES: June 11, 2022 Boded Thru Notary Public underwriters ' ff of �t�.:` Bonded Thru Notary Public UndervMters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE I MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17