HomeMy WebLinkAbout173 MedALL APPLICABLE INFO MUST RE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/912017
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: 173 Mediterranean Blvd N
Legal Description: St. Lucie Gardens Park of blocks 1 and 2
Property Tax ID #: 3426-500-1068-000-3
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace 40 Gallon electric water heater (like for like)
Lot No.
Block No.
0
CONSTRUCTION INFORMATION:
jai i—ona war to a er Orme un er t is permit — c ec a appy:
1=[71FIUAC - Gas Tank ❑Gas Piping_ Shutters 0 Windows/Doors
Electric 0 Plumbing Sprinklers Il Generator ❑ Roof L _� Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 800.00
OWNER/LESSEE:
Name Concetta Smith
Sq. Ft. of First Floor: _
Utilities: Sewer 1=J Septic
Andress: 173 Mediterranean Blvd N
City: Port St Lucie State: FL
Zip Code: 34952 Fax: —
Phone No. 772-785-9704
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Gary W Zanello
Building Height:
Company: Port 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@gmail.com
State or County License: CFC058025
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
F
i
o a e o ►t
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: 173 Mediterranean Blvd N
Legal Description: St. Lucie Gardens Park of blocks 1 and 2
Property Tax ID #: 3426-500-1068-000-3
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace 40 Gallon electric water heater (like for like)
Lot No.
Block No.
0
CONSTRUCTION INFORMATION:
jai i—ona war to a er Orme un er t is permit — c ec a appy:
1=[71FIUAC - Gas Tank ❑Gas Piping_ Shutters 0 Windows/Doors
Electric 0 Plumbing Sprinklers Il Generator ❑ Roof L _� Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 800.00
OWNER/LESSEE:
Name Concetta Smith
Sq. Ft. of First Floor: _
Utilities: Sewer 1=J Septic
Andress: 173 Mediterranean Blvd N
City: Port St Lucie State: FL
Zip Code: 34952 Fax: —
Phone No. 772-785-9704
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Gary W Zanello
Building Height:
Company: Port 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@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 LAIN 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
commencing work or recording our Notice of Commencement.
Ag -of ner/ Lessee/Contractor as Agent for Owner 4Siignf*ConorLicense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF-- COUNTY OFA
The forgoing instrugnqnt was acknowledged before me The forgoing instrue t was acknowledged before me
this /� day of % 20t7 by this dayaf [lC zp /7 6y
Gary W. zwdio 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
(Signature of Notary Public- tate of Florida) (Signature of Notary Public- Stat f /Flo-rida)
Commission No. FF9014099EY•• I �arllelle Iii 1Fso�ass
�4 �,-) 9 ICommission No. ..k1!.. (seal) Danielle Biglin
ac a►a COMMISSION OF 01099
EXPIRES: August 2 •2019 _+c -,a COMMISSION tFF90109
�F ; — EXPIRES: August 25, 201
., ��rlttlrns`o _ ���rs„rOFFl.`tip� ~ •
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
DATE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE
COMPLETED
lev. 8/2/17