HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO 'MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Dec. 20, 2017 Permit Number:
11NTY
F L O R I O A
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
El -
PROPOSED
PROPOSED IMPROVEMENT LOCATION:
Address: 903 Elyse Cir Port St. Lucie
Legal Description: Rivers Edge Block A Lot 4
Property Tax ID #: 3416-801-000-000-3
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 N o. 4
Block No. A
CONSTRUCTION INFORMATION:
Additional work to ff
orme un er t is permit— c ec a app y:
HVAC Gas Tank 0Gas Piping _ Shutters Windows/Doors
11 Electric F Plumbing Sprinklers Q Generator LJ Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 850.00
SFt. of First Floor: _
Utilities:cnSewer 0Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Warren Pearson
Name: Gary W Zaneilo
Address: 903 Elyse Cir
Company: Port St Lucie Plumbing
city: Port St Lucie State:F1
Zip Code: 34952 Fax:
Phone No.772 418-1602
Address: 6907 Heritage Dr
City: Port St Lucie State: FL
Zip Code: 34952 Fax: 772 489-9126
Phone No. 772468-6524
E -Mail: portstlucieplumbing@gmail.com
E -Mail:
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-
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Y Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
City:
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, l 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 your Notice of Commencement.
Signa a of ner/ Lessee/Contractor as Agent for Owner
A�
Sign f Con or/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF -tea
COUNTY OFA--
The forgoing instrument was acknowledged before me
The forgoing instru ent was acknowledged before me
this day of P(• 20 / by
thisqD day of G 20 1! by
Gary W. Zanello
Gary W. Z.anelIo
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
i
Y 7 e
(Signature of Notary Publ" t t florid%ammiSSION /ff901o99
(Signature of Notary Public-_ +�9oio9s
EXPIRES August 25, 2e}18
Commission No. so�aass �;ry W)AARONNATARY.COM
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- EXPIRES: August 25, 2019
Commission No. FFsuioss ''�� "''
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Rev. 8/2/17