HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
ti - J'= t_
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Building Permit Application
Planning and Developmem Services
Building and Code Regula'.ion 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: 8002 DELAND AVE
Legal Description: LAKEWOOD PARK -UNIT 6- BLK 62 LOT3 (MAP 13/02S)
Property Tax ID 4: 1301-606-0086-000-3
Site Plan Name:
Project Name: Beauchamp
Setbacks Front
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
40 GAL ELEC WATER HEATER REPLACEMENT
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work to b rtormed under this permit — check all apply:
E1HVAC Gas Tank Gas Piping rl Shutters Windows/Doors
11 Electric ✓❑ Plumbing Sprinklers ElGenerator E]Roof Roof pitch
Total Sq. Ft of Construction: .
Cost of Construction: $ 1310
S�Ft.j of First Floor: _
Utilities:I �lSewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Desiree V Beauchamp
Name: DIMITRE BOBEV
Address: 8002 DELAND AVE
Company: FLORIDA DELTA MECHANICAL
City.. FT PIERCE State:FIL
Zip Code: 34951 Fax:
Phone No. 718-344-5404
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:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Prone:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone: -
State:
Not Applicable
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 roams 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^ first inspection, If you _i.ntend to obtain financing, cg�ult with lender or an attorney before
com na g worlgor ret)rding your Nice of Commencemeht. I
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41 'ar S� b6,1-,
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORID
COUNTY OF E, [ f S
COUNTY OF 1( / , j ( ,-
The forgoing instrument was acknowledged before me
The fgrgoing instrument was acknowledged efore me
this � day of IN0V , 2012 by
this (J? day of UQV 20by
nu 11'e- 6 h.'64U
0 r t hT, 6 �2e,
Name of person making statement
Name of person making statement
Personally Known s2�__— OR Produced Identification
Personally Known O; OR Produced Identification
Type of Identification
Type of Identification
o laced
Produced
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(Signature of N ry
(Signature of
U U4 W Lr U I
He _11—
Y"
Commission
,+•u •. M MEDINA
MY Co
Commission
EMILY H. MED NA
;.= MY COMMISSION
No.
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EXPI ES: June 11. 2022
N
a IRES: June 1,
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Bonded Ttxu Notary Pu!7!ic Underwriters
��°c' bonded Thru Notary Public Underwriters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17