HomeMy WebLinkAboutBuilding Permit ApplicaitonALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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
I
PROPOSED IMPROVEMENT LOCATION:
Address: 24 LAKE VISTA TRL 202
Legal Description: VISTA ST LUCIE BLDG 24 UN7 202 (OR 3500-895)
Property Tax ID #: 3422-500-0331-000-9
Site Plan Name:
Project Name: MEDICO
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 to be performedunder this permit - check all apply:
11HVAC LJ Gas Tank Gas Piping _ Shutters O Windows/Doors
11 Electric �✓_ Plumbing 11 Sprinklers Generator 11 Roof = Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 798
Sq. Ft.
of First Floor: _
Utilities: []Sewer -.] Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Leonardo Medicc
Name: DUITRF BOBEV
Address: 24 LAKE VISTA TRL 202
Company: FLORIDA DELTA MECHANICAL
City: PORT ST LUCIE State: FL
Zip Code: 34952 Fax:
Phone No. 315-395-1457
Address: 8402 LAUREL FAIR CIR SUITE 111
City: TAMPA State: FL
Zip Code: 33610 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:
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 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
improv ments to your property. A Notice of Commencement must be recorded and posted on the jobsite
befor t e first i sped' n. If you interto obtain financing, co It with I nder or an attorney before
com en i wo k or ordi o otice of Commenceme t.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF t-I 1 S
STATE OF FLORIDA
COUNTY OF� $
The forgoing instrument was acknowledged before me
this S— day of , 20A� by
The for ing instrument was acknowledged efore me
this ?day of i(�� Q •VI , 20nby
rrn i try., li, b n)
_ a 01 El 1 xi
_
Name of person making statement
Name of person making statement
Personalty Known �? OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Prod ed
(Signature of N
Commission No.
(Signature of N � ic- ate i4I 5 INA
x• fir:
'' ,: MY COMMISSION # GG 227056
Commission No N p�Eg. )Ur{�Sq �
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r o` EXPIRES: June 11, 2022
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Rev. 8/2/17