HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _z �[,3 /2-02 0 Permit Number:
M A it'
•
ill
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: 7208 Maidstone DR
Legal Description: MAIDSTONE (PB 43-11) LOT 78
Property Tax iD #: 3322-505-0087-000-1
Site Plan Name:
Project Name: Kurt L Buck
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
50 GAL ELEC WATER HEATER REPLACEMENT
Lot No. —
Block No.
CONSTRUCTION INFORMATION:
Additional work to b
ff
r orme un er t is permit —c ec a app y:
In
OHVAC Gas Tank Gas Piping _ Shutters Windows/Doors
11 Electric ✓❑ Plumbing 11 Sprinklers Elenerator 1:1Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1298
5 Ft, of First Floor: _
Utilities: Sewer 1 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Kurt L Buck
Name: DIMITRE BOBEV
Address: 7208 Maidstone DR
Company: FLORIDA DELTA MECHANICAL
p Y=
City: PORT SAINT LUCIE State: FL
Zip Code: 34986 Fax:
Phone No. 346-739-8734
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
n VMUC ur cunstrucuon rs ;;�c5uu or more, a ntwrcutu 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 roams 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 fi inspection. If you intend to obtain financing, co It with I nder r an atforne efore
commencir ork or rkcordit your Notic�bf Commencemer r
�� /1' �'-' � -V �50 W
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
�
COUNTY OF # COUNTY OF tf(1 11 S
The for oing instrumen was acknowledged before me
this day of 20by
ml
Name of perso making statement
n Personally KnowOR Produced Identification
Type of Identification
P rod u_i
The f r ing instru t was acknowledge] before me
this day of 20 Z)1by
1 / I t' f 7ir
Name of plersgs `nn m' aking statement
Personally Known CX OR Produced Identification
Type of Identification
Produced
-
(Signature of NoE.0
{Signature of N
EMILY . MEQIidA
'r
S.Commission
' 'Commission
EMILYH. M DINA
No.MYcoM
#GG227050
;�?
No.
MYCOMMISSIOC 22705,
EXPIRES: June ]1, 2022
_ r
IitES:,lune it, 2022or
ded Thnt NioFary Puhfic Underwriters
''E °pP Bonded ThN Ho1ary Public Underwriters
OF Fy ,
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17