HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: March 03, 2017
Permit Number:
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
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 16 Lake Vista Trail 204 Port St Lucie
Commercial Residential X
Legal Description: Vista St. Lucie Building 16, Unit 204
Property Tax ID #: 3422-500-0221-000-5
Site Plan Name: Lot No.
Project Name: Block No.
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: -
Replace 30 gallon electric water heater (like for like)
CONSTRUCTION INFORMATION:
Additional work to bePerformed under this permit — check all apply:
HVAC D Gas Tank OGas Piping/
_ Shutters Windows/Doors
Q
0 - Electric 10Plumbing05prinklers ❑ Generator E] Roof �J Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 850.00
S Ft. of First Floor:
Utilities:Sewer 0Septic Building Height:
OWNERAESSEE:
Name David Porritt
Address: 16 Lake Vista Trail 204
City: Port St Lucie State: FL
Zip Code.. 34952 Fax:
Phone No. 772 359-1146
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Gary W. Zanello
Company: Port St. Lucie Plumbing
Address: 6907 Heritage Dr
City: Port St. Ducie State: FL
Zip Code: 34952 Fax: 772 489-9126
Phone No. 772 468-6524
E -Mail: portstlucieplumbing@gmail.com
State or County License: CFC058025
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Not Applicable MOkTGAGE 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 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 afull 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. If you intend to obtain financing, nsult with lender or an attorney before
comm acing work or recording your Notice of Commencern t.
I
4 .�
Signa of eressee/Contractor as Agent for Owner Signa r Corityt'orcense Molder
STPiTE OF FLORIDA STATE OF FLORIDA
COUNTY OF St L— COUNTY OF s--
The forging instr ment was acknowledged before me The fo►g ing instru ent was acknowledged before me
_. k/
this= -'' day of / - kz rLh 20 !! " by this 3IrC day of �Lrc i 20 ' by
Gary W. Zanello
(Name of person acknowledging)
/Jam.tAu A_/)/44rnl
(Signature of Notary Public- State of Florida )
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Personally Known Xq� _ uced fdN�ifilc�afibnn
Type of identification F d =_ COMMISSION OFF%11 U
August 25,
Commission No. 1111IFFS0109 ��` agNNQTA".COM
Revised 07/15/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
Guy W ZaneNo
(Name f person acknowledging)
(Signa re of Notary Public- State,$f Florida )
Personally Known x Xoduced i
Type AR" � ilt
T e o Identification P
' = EXPIRES: Mqug 25.2019
Commi sion No. FF901 1NWW IISIWOTAi{V.4()M
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEII� REVIEW REVIEW REVIEW