HomeMy WebLinkAboutBuilding Permit Application May 18 2015 08:20AM HP FaxFl Delta 8662190880 page 2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I Cf
Date: 5/18/2015 Permit Number: 1
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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
Address: 5500 DEER RUN DR
Legal Description: HOLIDAY PINES LOT 490
Property Tax ID ti: 1313-502-0067-000-2 Lot No.490
Site Plan Name: Block No.
Project Name: WILLIAM FOWLER
Setbacks Front Back: Right Side: Left Side:
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50 GAL ELEC WATER HEATER REPLACEMENT SAME FOR SAME
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ona wor to e •performed un ert is permit—c ec a yapp
HVAC Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 1110 Utilities: Sewer ElSeptic Building Height:
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Name
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IN 11L.. y �rir H,n.r'' 9 u./��x .iiGA 4
Name WILLIAM FOWLER Name: DIMITRE BOBEV
Address:5500 DEER RUN DR Company: FLORIDA DELTA MECHANICAL
City: FORT PIERCE State:FL Address: 2716 BROADWAY CENTER BLVD
Zip Code: 34951 Fax: City: BRANDON State:FL
Phone No.772-370-9674 Zip Code: 33510 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: CFC1425917
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
.May 18 2015 08:20AM HP FaxFl Delta 8662190880 page 3
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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:
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 whi ch 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. fy intend to obtain financing,consult with lender or �
ltorney before
commenci .k or rec our Notice of Commencement.
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_Signature of Owner/Les ee/Agent Signature of Contractor/License Holder
STATE OF FLOR D „� STATE OF FL RIQ 16bau in V)
COUNTY OF COUNTY OF
The f oing Instrument was acknowledged before me The fo,�going instr ment was acknowledge_rbefore me
this day of 20 Lby th is ( day of 20 by.
&YOU
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(Name of person acknowledging) (Name of person acknowledging)
IJIQ Q _Z_An A h2o X A.at
(Signature ol Notary Public-5 to of FI ida) (Signature c#Notary Public-S to of FI ida)
Personally Known__)�—OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
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Commission No :? r ASHL�4AICOLEZIEGENGEIw Commission Na. �l.y� 4� Seal
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a 398-01 53 Floridallotaryservice.com
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