HomeMy WebLinkAboutBuilding Permit Application Oct 26 2015 02:43PM HP Fax 9543847723 page 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l
Date: 1012612015 Permit Number:
RECEIVE®
Building Permit Application
Planning and Development Services OCT
2 6 2015
Building and Code Reguiation Division
2300 Virginia Avenue,Fort Pierre FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing
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Address: 4903 PALED PINES CIRCLE
Legal Description: HOLIDAY PINES LOT 325
PropertyTax ID#: 1312-801-0128-000-3 Lot No.325
Site Plan Name: Block No.
Project Name: RICHARD WILLIAMS
Setbacks Front Back: Right Side: Left Side:
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40 GAL ELEC WATER HEATER REPLACMENT
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AAdditional work to OGas
orme un ert is permit—c ec a appy:
OHVAC Tank OGas Piping _Shutters O Windows/Doors
Electric 0 Plumbing OSprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 1068 Utilities:11 Sewer O Septic Building Height:
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t 'k rz �y Is Ill sf,Y L �— ,er 4 '
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Name RICHARD WILLIAMS Name: DIMITRE BOBEV
Address:4903 PALEO PINES CIRCLE Company: FLORIDA DELTA MECHANICAL
City: FORT PIERCE State:FL Address: 2716 BROADWAY CENTER BLVD
Zip Code: 34951 Fax: City: BRANDON State:FL
Phone No,772-559-7362 Zip Code: 33510 Fax: 866-219-0729
E-Mail: Phone No. 866-219-0880
Fill in fee simple Title Holder an next page(if different E-Mail: FLPERMITS@DELTAMECHANICAL.COM
from the Owner listed above) State or County License: GFC1425917
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Oct 26 2015 02:43PM HP Fax 9543847723 page 2
A.MS.
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DESIGNE x ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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 Count, 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 firstin e ,
ction. If you i. end to obtain financing,consult with nder or an alto Fey before
commencingw rk r recor in r Notice of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Cont ctor/Livens Holde
STATE OF FLORID - STATE OF FLORIDA
COUNTYOF I COUNTYOF Ilk Y71 h
TheIng instr t as acknowledged before me The f oing instrumel was acknowledged before me
thisc ay of 20 LS3y this �iay of 20 LL by
(Name of person acknowledging) (Name of person acknowledging)
7-4 M.
(Signaturef Notary Public- ate of 05rida) (Signature of otary P\ubbIic-S e of Flo da)
Personally Known OR Produced Identification Personally Known J,-OR Produced Identification
Type of Identification Produced Type of identification Produced 1
Commission No.MQ (Seal) Commission No. a L l�! (� (Seal)
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EXPIRES M1Y 7, 2018 , 2011!
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