HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: March 26,2018 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: 12 Lake Vista Trail 202 Port St Lucie
Legal Description: Vista St Lucie Bldg. 12 Unit 202
Property Tax ID#: 3422-500-0163-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: 'Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace 30 gallon electric water heater (like for like)
CONSTRUCTION INFORMATION:
�`itiona workto e e orme under this permit—c ec a apply:
LJHVAC 11 Gas Tank []Gas Piping _Shutters Windows/Doors
11 Electric RI Plumbing Sprinklers E]Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 850-00 Utilities:,n Sewer 1:1 Septic Building Height-
OWNER/LESSEE: CONTRACTOR:
Name Ralph Manjarrez Name: Gary W Zanello
Address:2600 SE Ocean Blvd Company: port St Lucie Plumbing
City: Stuart State:FL Address: 6907 Heritage Dr
Zip Code: 34996 Fax: City: Port St Lucie State:FL
Phone No.317 331-8189 Zip Code: 34952 Fax: 772 489-9126
E-Mail: Phone No. 772465-8429
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: CF'C058024
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: T 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 contlict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your flame 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.
Signs a of ner/Lessee/Contractor as Agent for Owner Sign f Con or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFF-- COUNTY OFF
The f[Rr oing instr nt as acknowledge before me The forgoing instr e-rit was acknowledge before me
this day of 1MVI. 20 j by this 9T day of_f 1f 01 20 by
Gary W.Zaneiio ; ,�0i1_DmieligBl�ir� Gary W_Zanello
Name of person rgai tnentC�NIMISSIflN ifF90iQ99 Name of person rti s �ment 5FI9E�llC
Personally Known x tBR diced Id EaligEtt25.2i)i9 Personally Known x f}R dr d lds .4111
Type of Identification IMW
�.,,i ....• ' WAARONNOTARY.COM Type of Identification =.,;' ..,,. '��`
Produced +"'I ` Producedwww�RONNOFARY.C[,
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(Signature of Notary Publi -State of Florida) (Signature of Notary Public-S e of Florida)
Commission No. FR9OMM (Seal) Commission No. FR)07089 (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17