HomeMy WebLinkAboutbuilding permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: August 18,2017
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
r
PROPOSED IMPROVEMENT LOCATION:
Address: 28 Lake Vista Trail 107 Port St. Lucie
Legal Description: Vista St. Lucie Building 28, Unit 107
Property Tax ID#: 3422-500-0385-000-2
Lot No.
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTfON OF WORK:
Replace 30 gallon electric water heater like for like
CONSTRUCTION INFORMATION:
A J`itiona work to HV C e e orme un er t Es permrt-c ec a app y:
L=IA Gas Tank ❑Gas Piping n_Shutters Windows/Doors
LJ.
Electric 21 Plumbing Sprinklers 1i Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ 900.00 UtilitiescnSewer❑Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Lee Edstrand Name: Gary W.Zanello
Address:28 Lake Vista Trail 107 Company: Port St. Lucie Plumbing
City: Part St. Lucie State: Address: 6907 Heritage Dr.
Zip Code: 34952 Fax: City: Port St. Lucie State:FL
Phone No.954 829-2871 Zip Code: 34952 Fax: 772 489-9126
E-Mail: Phone No. 772468-6524
Fill in fee simple Title Holder on next page(if different E-Mail: Portstlucieplumbing@gmaii.com
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:
!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: Phone: zip: Phone_
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
1 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 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 our Notice of Commencement.
Ww I 4ae 9 Ak�� - -
Srgna a of nerj Lessee/Contractor as Agent for Owner Sign f Con orjLicense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF-- COUNTY OF-
The fo going instr ment w s acknowledged before me The f oing instrr ment w s acknowledged before me
this 7 day of U LUST 20L by this day of q U5 20 by
Garyw.Zaneka Gary W.7anello
Name of person making statement Name of person making statement
Personally known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
&Y, pvc JL W
Danielle aiglin Biglin
(signature of Notary Public-5 e of rri ?F= EXPIRE$ t ,I$ff§ture of Notary PublY9.S orid iRES.August 25,2019
' ,.�` WWWAARoNNc TARY.Com ,. ..... www.AARONNOIARY.COM
Commission No. FF9014099 'j�rr Ir Commission No. FF901099 "til ,+` (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17