HomeMy WebLinkAboutScanALL APPLICA LE INFO M//UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: V (i Permit Number:
s
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: 2730 Mohawk AVE
Legal Description: SAN LUCIE PLAZA SID -UNIT ONE- BILK 48
Property Tax ]D#: 1428-702-1034-000-6 Lot No.
Site Plan Name: Block No.
Project Name: William R Selph Jr
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
50 GAL ELEC WATER HEATER REPLACEMENT
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit — check all app y:
11HVAC L�9 Gas Tank E]Gas Piping _ Shutters O Windows/Doors
11 Electric 0 Plumbing U Sprinklers � Generator 0 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1498
5Ft of First Floor: _
Utilities: Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name William R Selph Jr
Name: DIMITRE BOBEV
Address: 2730 Mohawk AVE
Company: FLORIDA DELTA MECHANICAL
City: FORT PIERCE State: FL
Address: 8402 LAUREL FAIR CIR SUITE 111
Zip Code: 34946 Fax:
City: TAMPA State: FL
Phone No. 772-201-3411
Zip Code: 33610 Fax: 866-219-0729
E -Mail:
Phone No. 866-219-0880
E -Mail: FLPERMITS@DELTAMECHANICAL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: CFC1425917
IT value of construction Is X2500 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:
City: State:
Address:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: ^ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
°=
aF F�°. ` Bonded Thru Notary Public Underwriters
REVIEWS
v VV 1VGn/ SUN t RKx.I UK E►hrlUYl I: 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 fir t inspection. If you intend to obtain financing, consult with lender or an attorney before
commenci ork or r cordi our Notice of Commencement.
7 Z
r
�~ ,.
Signature of Owner/ Lessee/Con racto as Agent for Owner Signature of Contractor/License H Ider
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF tA,, 11 S COUNTY OF
The for oing instru ent was acknowledged before me
this day of 20y
Name of person making statement
Personally Known C— OR Produced identification
Type of Identification
Produced
The far oing instr ent was acknowledged before me
this day of m , 20-jby
Name of person making statement
Personally Known _0 OR Produced Identification
Type of Identification
Produced
(Signature of No
(Signature of Nota
Commission No.
5„¢ P EMIL. EDINA
"" MY COMMI # GG 227056
.:)
Commission No.
t;"•".G EMILY H. MEDINA
MY Go GG 227056
a o: EXPIRE :dune 11, 2022
�_
:' s EXPNtES: t il, 2022
9pRded Thru Notary PUblsc t)rdervmters
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aF F�°. ` Bonded Thru Notary Public 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