HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: August 28,2017 Permit Number:
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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: 391 SE Solaz Ave. Port St. Lucie
Legal Description: River Park Unit 6 Block 57 Lot 16
Property Tax I D#: 3419-545-0034-000-6 Lot No 16
Site Plan Name: Block No. 57
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace hall bath tub and shower valve (like for like)
CONSTRUCTION INFORMATION:
Additional wor to be + r orme un er t Is permit—c ec a app y:
�HVAC Gas Tank OGas Piping _Shutters windows/Doors
L=1 Electric L f Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 5 . Ft.of First Floor:
Cost of Construction:$ 750.00 Utilities:Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Thomas Davis Name: Gary W.Zanello
Address,-4 Overlook Dr. Company: Port St. Lucie Plumbing
City: New Milford State:Ct Address: 6907 Heritage Dr.
Zip Code: 06776 Fax: City: Port St. Lucie State:FL
Phone No.407 747-5476 Jay/Lyn Marino Zip Code: 34952 Fax: 772 489-9126
L-Mail: Phone No. 772468-6524
Fill in fee simple Title Holder on next page( if different E-Mail: Portstlucieplumbing@gmail.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.
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 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
commencin work or recordingour Notice of Commencement.
-A va'w - __
Slgna a of ner/Lessee/Contractor as Agent for Owner Sign of Con or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF-- COUNTY OF---
The for oing instr ment w s acknowledged before me The fo oing instr ent wa acknowledged before me
this day of S 2t1__,7 by this�day of /'1(� Gt�� 2611 by
Gary w.zaneilo Gary W.Zanello
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
�. t�}✓1rJ� � nielle Bi tin Danielle Bi lin
(Signature of Notary Publfc? J Io6d4&m1Ss10N *Ff901099 (Signature of Notary Pubffi 5 loridkpikMISSION #FF901099
Exp►RES:August 25,2019 ExPIRES:August 25,2019
Commission.No. FFS014099 %, $;.' WwIM1i0NNOTARY.00M Commission No. FFUD1099 %.` � .�` W JI)NNOTARY.COM
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17