HomeMy WebLinkAboutBuilding Permit Application -Mar 18 2016 07:45PM Florida Delta Mechanical 8662190729 page 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n
Date: 3/18/2016 Permit Number:
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Building Permit Application ��p q
Planning and Development Services MM 1 12016
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
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Address: 1300 SCOTT STREET
Legal Description: INDOAN RIVER ESATES BLK 40 LOT 14
PropertyTax ID#: 3402-608-0089-000-6 Lot No.14
Site Plan Name: Block No. 40
Project Name: WILLIAM WARD
Setbacks Front Back: Right Side: Left Side:
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40 GAL ELEC WATER HEATER REPLACEMENT
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Addlitionalworktope erformed under tIs perm —cneck all appy:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric 0 Plumbing ❑Sprinklers []Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1169 Utilities:Sewer O Septic Building Height:
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Name WILLIAM WAND Name: DIMITRE BOBEV
Address:1300 SCOTT STREET Company: FLORIDA DELTA MECHANICAL
Com: FORT PIERCE State:FL Address: 2716 BROADWA`!CENTER
Zip Code: 34982 Fax: City: BRANDON State:FL
Phone No.772-695-6419 Zip Code: 33510 Fax: B66-219-0729
E-Mall: 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.
Mar 18 2016 07:45PM Florida Delta Mechanical 8662190729 page 2
DESIGNER/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 certifythat 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 structueps,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO. WNER:Your failure to Record a Notice of Commencement may r t in your paying twice for
improvements o your prop .A Notice of Commencement must be record d nd osted on the jobsite
before the first sp io . 4 u intend to obtain financing,consult with len er r a o ey before
commencingklo c r Notice of Commencement.
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_Signature oftoo
s gen Signature of Contractor/Ll ens o er
STATE OF FLSTATE OF FLOR D
COUNTY OF COUNTY OF
The f ping int s acknowledg d before me The forgoing instru en w acknowledge efore me
this day 201 aby this JSdayof 20 LLL by
DIM-14Y.0- QDW D,fflm 6wf. /
(Name of person acknowledging) (Name of person acknowledging)
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(Signature of N try Public-State 0 Florld ) (Signature of Cotary Public-StateJDf Flori )
Personally Known_)4—OR Produced Identification Personally Known %�--OR Produced identification
Type of Identification Produced Type of Identification SProduced
Commission No. Seal Commission No,T?— (Seal)
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ASHLEY NICOLE ZIEGENG 1ST ASH=NICOLE ZIEGENGEIST
MY C MM �212 `i j MY COMMISSION#FF120712
Revised 07!15/2014 ?p,ti EXPIRES May 7.2018 ;f;4 XPIRES May 7,2018
(407)398-01543 F1nrtdallotary9ervt:e.com n
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