HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
F L U R 1 D A
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 X
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Plumbing
Dpnpnc.Fn IMPROVEMENT LOCATION: _
Address: 5146 Waterside WAY Fort Pierce, FL 34981
Legal Description: RIVER BRANCH ESTATES LOT 16 (0.57 AC) (OR 1604-1007; 2054-2961; 3965-2181)
Property Tax ID #: 3404-809-0020-000-8
Site Plan Name:
Project Name: Atef M Gayed
Setbacks Front Back: Right Side
DETAILED DESCRIPTION OF WORK:
50 GAL ELEC HYBRID WATER HEATER REPLACEMENT
Left Side:
Lot No.
Block No.
CONSTRUCTION INFORMATION:
T i al work to e er orme un er t is permit — c ec
❑_
a app y:
❑ Windows/Doors
HVAC Gas Tank Gas Piping
_Shutters
❑Electric 0 Plumbing Sprinklers
❑ Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
❑ Building Height:
Cost of Construction: $ 2048 Utilities
Sewer Septic
OWNER/LESSEE:
CONTRACTOR:
Name Atef M Gayed
Name: DIMITRE BOBEV
Address:5146 Waterside WAY
Company: FLORIDA DELTA MECHANICAL
City: FT PIERCE State: FL
Address: 8402 LAUREL FAIR CIR 111
Zip Code: 34981 Fax:
CityState: FL
: TAMPA
Phone No, 772-480-5679
Zip Code: 33610 Fax: 866-219-0729
E-Mail:
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ! Not Applicable MORTGAGE COMPANY: r 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
structure. Please consult with pyoiur appHome licable
Owners Associationrs ndrreviewyy ur deed for any restr ctio s wh which marestricty apply. 'bit such
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 inten to obtain financing, consult with lender or an attorney before
rSignatu
mm n wor or r rdin our ice of Commencement
r
A( a 1 R( D
a of Owner/ Lessee/Contractor as Agent for Owner Signature f Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The f going instrument was acknowledged efore me
this going
day of ZV 20-Uby
Name of pers n making statement
Personally Known 0k OR Produced Identification
Type of Identification
Produced
STATE OF FLORIDA S
COUNTY OF HT Ll
The forgoing instrument was acknowledged before me
this _2_1 day of U J 20L3 by
El
I.
ame of person making statement
Personally Known M OR Produced Identification
Type of Identification
Produced
(Sign4.ature of Notary blic-
(Signature of Notary__
H. NiERINA
Commission No.
MYL'S� OSION#GG227056
Commission No.
x' EXPIRES: June 11, 2022
Banded T'nru h0"r, PuNic Undervmlers
REVIEWS
FRONT
ZONING SUPERVISOR
PLANS VEGETATION
COUNTER
REVIEW REVIEW
REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
EhIILY H. MEDNA
LdY COMMIS�1$I4%G 227056
EXPIRES: June 11, 2022
Gonded Tnru No'nry Pub5c Underwhlers
SEA TURTLE I MANGROVE
REVIEW REVIEW