HomeMy WebLinkAboutScanALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2 G Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Fierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 9419 Pinebark CT
Legal Description: MONTE CARLO COUNTRY CLUB -UNIT ONE- LOT 155
Property Tax ID #: 1327-801-0044-000-6
Site Plan Name:
Project Name: Courtney Miller
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
40 GAL ELEC WATER HEATER REPLACEMENT
Lot No._
Block No.
CONSTRUCTION INFORMATION:
Additional work to b
je�e orme under this permit — c ec a apply:
11HVAC L _j Gas Tank []Gas Piping _ Shutters Windows/Doors
11 Electric Z Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1278
S Ft. of First Floor: _
Utilities:cn Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Courtney Miller
Name: DIMITRE BOBEV
Address: 9419 Pinebark CT
Company: FLORIDA DELTA MECHANICAL
City: FT PIERCE State: FL
Zip Code: 34951 Fax:
Phone No. 561-345-1618
Address: 8402 LAUREL FAIR CIR SUITE 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:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE BOLDER: 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 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
commencin rk or re ordin your Notice of Commenceme
Signature of 0 ner/ Lesse /Contr ctor Ys Agent for Owner &gnat a of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA Lf
COUNTY OF 1 COUNTY OF
The for oing instrument was acknowledged before me
this day of mb 202D by
Name of person making statement
Personally Known C� OR Produced Identification
Type of Identification
Produced
The f r ing instrument was acknowledged before me
this Vday of +1Ae� 2020by
f d,&,cJ
Name of perso making statement
Personally Known OR Produced Identification
Type of Identification
Produced
t222i 22z et��
,-
(Signature of I' t e of Florida) (Signature of Notar -
�,.;• Y EMILYH. r_ -Yeagc ! Ei/ilLl' H.M"cGllr'.'
Commission N " r-": Commission o issioN 4 q64 �sb
MMISS) 01V # G 227056 �: =
' EXPIRES: June 11, 2022
EXPIRES: June 11, 2022 Bonded Thru Notary Pub is Und.rwr tars
BOME41 Thru Notary Public Undemnters —
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17