HomeMy WebLinkAboutBuilding Permit ApplicationALL. APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:T�
Permit Number:
MUM 19
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: 4250 N AIIA Apt 1206
Legal Description: OCEAN HARBOR SOUTH BLDG A UNIT 1206 AND UND INTEREST IN COMMON ELEMENTS (OR 1078-1023)
Property Tax ID #: 3327-502-0196-000-4
Lot No.
Site Plan Name:
Block No,
Project Name: Ronald Winkelman
Setbacks Front Back: Right Side:
Left Side:
DETAILED DESCRIPTION OF WORK:
30 GAL ELEC WATER HEATER REPLACEMENT
[CONSTRUCTION INFORMATION:
Additional work to e ertormed under this permit . check
all apply:
0HVAC Gas Tank Gas Piping
_ Shutters ❑ Windows/Doors
11 Electric ❑✓` Plumbing Sprinklers
Generator Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor
Cost of Construction: $ 1034 Utilities: Sewer Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Ronald Winkelman
Name: DIMITRE BOBEV
Address: 4250 N Al Apt 1206
Company: FLORIDA DELTA MECHANICAL
Address: 8402 LAUREL FAIR CIR SUITE 111
City: FT PIERCE State: FL
TAMPA State: FL
City'
34986
Zip Code: Fax:
Phone No. 508-314-1937
Zip Code: 33610 Fax: 866-219-0729
E-Mail:
Phone No. 866-219-0880
Fill in fee simple Title Holder on next page ( if different
E-Mail: FLPERMITS@DELTAMECHANICAL.COM
from the Owner listed above]
State or County License: CFC14251117
1f value of construction is $7500 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: 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 y work or installation has commenced prior to the issuance of a permit..
St.
is inconflictwith any applicableion HomeaOiwners Asssociati Association ruleswill aby bylaws or and covenapermit nts that may restrict subject
proh bit 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, co ult vyith lender or an attorney before
comment' ork or ecor odr Noti of Commenceme - z ----
r I
r
xr a
Signature o Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF /
The forgoing instrument was acknowledged before me The forgoing instrume t was acknowledged before me
this � day of 202oby this , day of Gti'j 2020'by
Name of person making statement
Personally Known O( OR Produced Identification
Type of Identification
Produced
(Signature of ; 'fy . ic- Sta .Of flMWIJA
"*= MY COMMISSION # GG 227056
Commission *'
ES: JunA5tid422
Bonded Thru Natary Public iind riYT r.'s
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
Name of person making statement
Personally Known OK OR Produced Identification
Type of Identification
Produced
(Signature of No ry Public- State of Florida t
Commission N ""• : i EMIL`f H. IA�§
Y" w AISSION GM7056
E}CP]RES: June 11, 2022
SUPERVISOR I PLANS VEGETATION ! SEATURTLE MANGROVE
REVIEW REVIEW REVIEW I REVIEW REVIEW