HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
- J
� rr
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: 9418 Bunting LN
Legal Description: MONTE CARLO COUNTRY CLUB -UNIT TWO- LOT 152 (OR 3847-191)
Property Tax ID #: 1334-502-0069-000-1
Site Plan Name:
Project Name: Mitchell L Hall
Setbacks Front Back
Right Side: Left Side:
Lot No.
Block No.
IDETAILED DESCRIPTION OF WORK: I
40 GAL ELEC WATER HEATER REPLACEMENT
CONSTRUCTION INFORMATION:
Additional work to b rtormed under tispermit—check all apply:
CIHVAC Gas Tank Gas Piping _ Shutters Windows/Doors
Electric ❑✓� Plumbing [] Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 1310
S Ft. of First Floor: _
Utilities:cnSewer OSeptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Mitchell L Hall
Name: DIMITRE BOBEV
Address: 9418 Bunting LN
Company: FLORIDA DELTA MECHANICAL
Address: 8402 LAUREL FAIR CIR SUITE 111
City: TAMPA State: FL
Zip Code: 33610 Fax: 866-219-0729
Phone No. 866-219-0880
City: FORT PIERCE State:F L
Zip Code. 34951 Fax:
Phone No. 614-747-6163
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: Prone:
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
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the rst inspection. If you intend to obtain financing, co It with I nder or an attorney before
commen n A work or recur n our Noti of Commenceme
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE
COUNTY OF FLORIDA I � 1 '1 5
STATEFLORIDA
COUNTYOF
The for ing instrume t was acknowledged before me
The fo oing instru ent was acknowledged before me
this day of , 20 0 by
this day of 20L by
V' rn } h
- I�Y1 Izav
Name of per s making statement
Name of person making statement
Personally Known � OR Produced Identification
Personally Known a OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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(Signature of No4 DINA
(Signature of Nota
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Commission No. =_ MY CflMM1S$ ON if GG 227355;yy:
1,2022
EMiLY H. MEDIi�A
Commission No. MYCOMM !"f GG227056
EXPli2ES
QOfldEd ThruNotatyPcblirUnderv'•
=a•. _Q_ F�(PfftES:June 1t,2022
'•.Fcr Fi°.' Thry Nola Public Underwriters
_
Sonded
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17