HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: March 09, 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 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 9401 Avenel Ln Port St Lucie
Legal Description. Pines at the Reserve Lot 13
Property Tax ID #: 3322-502-0019-000-5
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Replace 50 gallon electric water heater (like for like)
Lot No. 13
Block No.
CONSTRUCTION INFORMATION:
Additional work to ofIrformed under tis permit— check all apply:
❑HVAC Gas Tank E]Gas Piping nGenerator
Shutters Windows/Doors
11Electric LrJ Plumbing Sprinklers ❑ Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 225-00 Utilities:
Sq. Ft. of First Floor:
Sewer 0 Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Randy Bullis
Name: Gait W. Zaaello
Address: 9401 Avenel Ln
Company: Port 5t. Lucie Plumbing
p Y=
City; Part St. Lucie State: FL
Address: 6907 Heritage Dr
Zip Code: 34986 Fax:
Phone No. 772 466-6795
City: Fort St. Lucie State: FL
Zip Code: 34952 fax: 772 489-9126
E -Mail:
Phone No. 772 468-6524
E -Mail: Portstiucieplumbing@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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:
DESIGN
Not
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
llp Phone:
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip:_ Phone:
BONDING COMPANY: Not Appllcable
Name:
Address:
city.
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 Folder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or anc3 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 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, consult with lender or an a
commencing work or recordingour Notice of Commencement. ttorney before
as Agent for Owner
STATE OF FLORIDA
COUNTY OF st Luon
The f r oing in nt as acknowledged before me
this day of 20 Lby
Gary w Zanetlo
(Name of person acknowledging)
(Signature of Notary Public -
Personally Known x
Type of identification
of Florida)
Idenl!I""limon
Commission No. E7tlMRAR Augur 25, co m
Frsa�oss
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
COMPLETE
INITIALS
STATE OF FLORIDA
COUNTY OF sr_
The rgoing instrum nt was cknowledged before me
thisday of 20 by
Gary w. Zanello
(Name of person acknowledging)
(Signature of Notary Public- State of orida )
Personally Known x .�i 11 r,}uced IdeQN044"in
Type of Identification Psi u` = pDMMiSfiIOk iFF9G1099
EXPIRES: Aupuft .
Commission No. PF901 ; .. ��*' y &"NOTARyM
REVIEW VEGETATION
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