HomeMy WebLinkAboutScan_0001ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I Z020 Permit Number:
-' 'J
Building Permit Application
Planning and Development 5ervices
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: 9450 Meadowood DR Apt 204
Legal Description: QUAIL RUN VILLAGE BLDG 3 UNIT 204
Property Tax ID #: 1327-703-0034-000-2 Lot No.
Site Plan Name: Block No.
Project Name: Tessa M Black -Burton
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: I
40 GAL ELEC WATER HEATER REPLACEMENT
CONSTRUCTION INFORMATION:
itiona rk toe e orme m
under this per --check a appy:
HVAC [] Gas Tank E]Gas Piping _Shutters Windows/Doors
Electric 2 Plumbing 11 Sprinklers 11 Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1428
S Ft. of First Floor:
Utilities:Sewer E Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Tessa M Black -Burton
Name: DIMITRE BOBEV
Address: 9450 Meadowood DR Apt 204
Company: FLORIDA DELTA MECHANICAL
City: FT PIERCE State: F'L
Zip Code: 34951 Fax:
Phone No. 766-564-8463
Address: 8402 LAURE; FAIR CIR SUITE 111
City: TAMPA State: FL
Zip Code: 33610 Fax: 866-219-0729
Phone No. 866-219-0880
E -Mail: FLPERMITS@DELTAMECHANICAL.COM
State or County License: CFC1425917
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
IT value or construction is >tsuu or more, a KLCURVED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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
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�ie first iryspectign. If you intepd to obtain financing, co ult with lender or an attorney before
comn�(enkine wolk or rbtordiw voVNotice of Commencemerft. 1 f
Rev. $/2/17
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF (� _ _ _ _
COUNTY OF I 1 S
The fo oing instrument was acknowledged before me
The for oing instrument was acknowledged before me
this II day of JOrIUG h. �, 20��by
this: day of )0rx,(>YU 202Dby
► n�ce &
Name of person making statement
Name of person making statement
6-�
Personally Known �_ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Not
,.• M1L MEOINA
(Signature of Not
EMILY . MS DINA
Commission No.
=� MY COM N IF GG 227056
Commission No. = MY cOMMI p 4. GG 227056
EXPIRES: June 11, 2022
_ o= EXPIRES: June 11, 2022
Bonded Thnr Notary Public Underwriters
O€F Bonded Thru Notary Public, Underwriters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev. $/2/17