HomeMy WebLinkAboutBuilding Permit Application Jun 02 2015 07:24AM HP FaxFl Delta 8662190880 page 1
ALL APPLIC LE
I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ts? Permit Number: 5 alb o Q
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone:(772)462-1553 Fax: (772)462-2578 Commercial Residentia I X
PERMIT APPLICATION FOR: Plumbing
If• �
r 91 .L
Address: 242 NE JARDAIN ROAD
legal Description: RIVER PARK UNIT 9 BLK 73 LOT 23
Property Tax ID#: 3419-565-0029-000-0 Lot No.23
Site Plan Name: Block No. 73
Project Name: CLARA BECKLEY
Setbacks Front Back: Right Side: Left Side:
.
a
50 GAL ELEC WATER: HEATER REPLACEMENT
Add _ 3
itional work o be performed under isperm —c eckall appy:
HVAC 0 Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric Fv/1 Plumbing �Sprinlclers Generator Roof
Total Sq.Ft of Construction: Sq.Ft. of First Floor:
Cost of Construction:$ 1039 Utilities:0 Sewer❑Septic Building Height:
1-1 PW
a EN
0, Wlr2 IN EN
Name CLARABECKLEY Name: DIMITRE BOBEV
Address:242 NE JARDAIN ROAD Company: FLORIDA DELTA MECHANICAL
City: PORT SAINT LUCIE State:FL Address: 2716 BROADWAY CENTER BLVD
Zip Code: 34983 Fax: City: BRANDON State:FL
Phone No,772-353-5962 Zip Code: 33510 Fax:
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.
Jun 02 2015 07:24AM HP FaxFl Delta 8662190880 page 2
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_5, G MORTGAGE
DESIGNER/ENGINEER: _Not Applicable' 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
is ICounty fli makes no
any appl�canblelHome Owners tAssociationirwill
esabylaws or and cove ants that build
drestrict or prohib`t 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 an the jobsite
before the first inspection. yo intend to obtain financing,consult wLth lender or orney before
commenci o I<or reco 810wour Notice of Commencement. "
.411
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_Signature of Owner/Lessee/Agent Signature of Contractor/Lic nse Holder
STATE OF FLOSTATE OF FLO I
COIL1NTYOF—V?11 'q, XY -i ich COUNTY OF
{
The forgoing instru ent was acknowledged, efore me The for oing instrument was cknowled a before me
this day of 20 by this day of 201 by
i a i Ewpv_
(Name of person acknowledging) ( ame of person acknowledging)
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(Signature of otary Public-Stat(lof Floridt)— (Signatur of Notary Public tate o lorida)
Personally Known Y_ OR Produced Identification Personally Known.�OR Produced identification
Type of Identification Produced Type of Identification Produced
Commission No-FE12071 VZ (Seal) Commission ASML, ICOLEZIEGENGEIS
it ' MY COMMISSION#FF120712
CNV PV y
ASHLEY NICOLE ZIEGENGEiST EXPIRES May 7, 2018
Revised 07/15/2014
i+� MY COMMISSION#FFt 20712 (407)308.0100 PlorldnNNateryySSeervice.com
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