HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: May 10, 2017 Permit Number:
c0UNTY
F L 0 R 1 D A -'jo
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: 780 SE Hidden River Dr_ Port St Lucie
Legal Description: Hidden River Estates
Property Tax ID ##: 3427-701-0063-000-1
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace 50 gallon electric water Neater (like for like)
Lot No. 28
Block No. 3
El
CONSTRUCTION INFORMATION:
Additional work to be Performed under this permit— check all apply:
LIHVAC Gas Tank OGas Piping Shutters Windows/Doors
OElectric RI Plumbing OSprinklers Generator Roof I Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 800.00
Sq.Ft.of First Floor:
Utilities: LSewer 0Septic Building Height:
OWNER/LESSEE:
Name Paul Lucas
Address: 780 SF Hidden River Dr
City: Port St Lucie State:FL
Zip Code: 34983 Fax:
Phone No. 772 878-0528
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Gary W. Zanello
Company: fort St Lucie Plumbing
Address: 6907 Heritage Dr
City: Port St Lucie State: FL
Zip Code: 34952 Fax: 772 489-9126
Phone No. 772 468-6524
E -Mail: portstlucieplumbing@a gmail.com
State or County License: CFC058025
If value of construction is $2504 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER; Not Applicable MORTGAGE 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: Rhone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit_
St. Lucie County mattes 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 Horne Owners Association and review your deed for any restrictions which may appty.
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 Am n.,J. ,. ,, -.J.
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 attorney before
commencing work or recording your Notice of Commencement.
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Signa u ng d�er/Lessee Contrac[orasAgentforQwner 5igssatrtreo Co or/License14older
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5t'ArT?E OF FLORIDA STATE OF FLORIDA
COUNTY OF s- L --w COUNTY OF s
The f0f gi] ' j! ?rpt } add wledged before me
this /L� I iK$y of rv"ela l 20 Llby
Gary W 7MIR,
(Name of person acknowledging)
'A ZAV I-
(Signature of Notary Public- to of Florida }
The forge ng instr +um nt was acknowledged before me
this � y of I �% , Zo /7 by
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Gary w. X10
(Name of person acknowledging)
(signature of Notary Public- State of FI{ da )
Personally Known x OR Produced Identification Personally Known x �R Produced identification _
Type of Identification Prod Type of Identification, T}i$jQ(in
�t/��r'� Qtniel�— caMM1 10N FF$0109g
FF�1tl9> SSION FF901099 Commission 1110_ �=
Commission No. a►° = k7(PoREit 25, 2Q19
S; August 25, 2013
4f1YW.AARONNOTARY.COM '11iq,11`u`e``�. 1YiAW AARONNOTAAY.COM
Revised 07/15/2014
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