HomeMy WebLinkAboutBuilding permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /'`-!� r Permit Number:
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
f PERMIT APPLICATION FOR: Plumbing
Residential X
PROPOSED IMPROVEMENT LOCATION: I
Address: 4906 Lakewood Park DR
Legal Description: LAKEWOOD PARK -UNIT 1- BLK 4 LOTS11 AND 12 (MAP 13/14N) (OR 899-935: 4245-1084)
Property Tax ID #: 1301-601-0042-000-8
Site Plan Name: Barbara L Sutorka
Project Name: Barbara L Sutorka
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 orme under
�HVAC n
this permit — check
Gas Piping
a apply:
Shutters
Windows/Doors
Gas Tank
_
Electric ❑✓1 Plumbing
11 Sprinklers
ElGenerator
E]Roof Roof pitch
Total Sq. Ft of Construction:
1478
S Ft. of First Floor:
O
Cost of Construction: $
Utilities:
Sewer Septic
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name Barbara L Sutorka
Address:4906 Lakewood Park DR
Name: DIMITRE BOBEV
Company: FLORIDA DELTA MECHANICAL
City: FT PIERCE State: FL
Zip Code: 34951 Fax:
Phone No. 772-528-5517
Address: 8402 LAUREL FAIR CI 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: I
DESIGNER/ENGINEER: — Not Applicable
Name:_
Address:
City:
Zip:
Phone
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:_
Address:
City:_
Zip:
Phone:
Not Applicable
ate:
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 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 intend to obtain financing, consult with lender or an attorney before
cammencifi—iNwork orrrecordinE vour Notice of Commencement.
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Signature 6f Owner/ Lessee/Contractor as Agent for Owner
Sign e f L6n4@-c^t6r/LJeeYs6r34fler
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF_ B,
COUNTY OF
The for ping instru t was acknowledged ?,efore me
The forping instruriptnt was,acknowledg eft efore me
this day of ! C 20! �by
this day of 20�-+by
.
Name of person making statement
Name of person making statement
Personally Known (-jL_ OR Produced Identification
Personally Known _ Q( OR Produced Identification
Type of Identification
Type of Identification
Produced
JA/_
Produ ed `
(Signature of No
"•. EMI EQIPIA
{Signature of Notary
+*u EMi Y H. MEQINA
,: MY COMMIS GG 227456
Commission No. :: �1
6 t_ MY CON�I 227056
Commission No. ; jL 2022
o: EXPIRES: June 11, 2022
._�•• :Q; E}(P E ne tl,
Bonded Thm Notary Public Undetwrlters
'�'. of ey°�' BMW Thru Notary Public Undewfters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17