HomeMy WebLinkAbout9206 wentworthALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
_-,J .
•
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 XX
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 9206 Wentworth Lane Port St Lucie
Legal Description: POD 20A At the Reserve PUD II Castle Pines Lot 82
Property Tax ID #: 3327-801-0090-000-9
Site Plan Name:
Project Name:
Setbacks Front Back
Right Side: I Left Side:
DETAILED DESCRIPTION OF WORK:
Replace single handle master bath shower valve (like for like)
Lot No. 82
Block No.
CONSTRUCTION INFORMATION:
Add itionai work to be performed under this permit —,heck a appy:
HVAC Gas Tank [JGasPiping _ Shutters O Windows/Doors
11 Electric ® Plumbing Sprinklers Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 550.00
Sq. of First Floor: _
Utilities: L 1Sewer 11 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NamePaul Clark
Name: Gary W Zanello
Address:23 Kellie Dr
Company: Port St Lucie Plumbing
City: Pittsfield State:MA
Zip Code: 01201 Fax:
Phone No. 772 828-9244 Bridgett
Address: 6807 Heritage Dr
City: Port St Lucie State: FL
Zip Code: 34952 Fax: 772 489-9126
Phone No. 772 468-6524
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: POrtstlucieplumbing@gmaii.com
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:
Address:
(MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
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 permitwill authorize the permit holderto 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
commencine work or recordine vour Notice of Commencement_
ill 6 W V1, I a, 9
--
51gna a of ner/ Lessee/Contractor as Agent for Owner
Sign f Con or/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF---
COUNTY OF --
The forgoing instrupent was acknowledged before me
The f r oing Instrjrt'ent was acknowledged before rine
done le
this day of Ll 20 by
this lay of
20 by
GaryW_ ZaneHo
Gary W. Zamilo
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
Danielle BEglin
�' `��%ra Danielle Qiglin
COMMISSION #fP901099UMMISN"IFF991099
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August
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(Signature of Notary P*51bri
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Commission No. FF9014099 (Seal)
Commission No. FF901099
" i," (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. $/2/17