HomeMy WebLinkAboutBuildling permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12-� l 1 - t_ l _ Permit Number:
J =
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 6007 Tangelo DR
Legal Description: INDIAN RIVER ESTATES -UNIT 09- BLK 83 LOT 27 (MAP 34111 S)
Property Tax ID #: 3402-610-0379-000-3 Lot No._
Site Plan Name: Cathy L Weiss Block No.
Project Name: Cathy L Weiss
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: I
40 GAL ELEC WATER HEATER REPLACEMENT
CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit — check a apply:
�HVAC be
Tank ❑Gas Piping _Shutters Windows/Doors
Electric Z Plumbing U Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: .
Cost of Construction: $ 1428
S Ft. of First floor: _
Utilities:11Sewer Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Cathy L Weiss
Name: DIMITRE BOBEV
Address:6007 Tangelo DR
City: FT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No. 607-968-1333
E-Mail:
Company. FLORIDA DELTA MECHANICAL
Address: 8402 LAUREL FAIR CiR 111
City: TAMPA State: FL
Zip Code: 33610 Fax: 866-219-0729
Phone No. 866-219-0880
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:
Zi p: 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
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
commencing -work or rpcordi_qg your.Notice Rf Commencement.
r
� )'_t' �." I .9r L 9Z
�
� ), � "� 1 9 , �" /�
Signature of caner/ Less a/Con acto as Agent for Owner
Signature o Contracto Licens of
STATE OF FLORIDA
COUNTY OF S
STATE OF FLORIDA
_
COUNTY OF
The fo oing instr ent was acknowledged before me
this -M day q
The fo oing instru ent w s ackngwlle�d�e�i efore me
� day ei1'� �by
of 26 by
this of _ _ rlC� l
t
tWL
Name of person making statement
Name of person making statement
Personally Known 0_ OR Produced Identification
Personally Known ()(— OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
-
On4lt�' �
YJ�/
(Signature of Not
_
(Signature of IN
INA
Commission No.
•''�a*v,�". EMILY H. MEDINA
_ °'
COMMtSGG227{!5fi
Commission No
.. 61l
""�r�.
•: .,_ MYCOMMISSIC�} G 27056
42
_
-° a: EXPIRES: June 11, 2C22
a: if2ES:Jun�E
�-Fa+'FLO ' Bonded Thru Wary Public Underwriters
F °� F '•' Bonded Thru Notary Pub it 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