HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: July 11, 2018
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 XX
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 18 Lake Vista Trail 102 Port St Lucie
Legal Description: Vista St Lucie Building 18 Unit 102
Property Tax ID #: 3422-500-0240-000-4
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace 30 gallon electric water heater (like for like)
CONSTRUCTION INFORMATION:
Arc ditiana work to e)ej r orme un er t �s permit — c ee a y :
app
HVAC Gas Tank F]Gas Piping _ Shutters
Electric 21 Plumbing 11 Sprinklers LJ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 900.00
OWNERAESSEE:
Name Ruth V. Kobey
AdrIrPss.18 Lake Vista Trail 102
S. Ft. of First Floor:
Utilities: Sewer E Septic
City: Port St Lucie State:FL
Zip Code: 34952 Fax:
Phn,P Nn_772 785-8310
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Gary W. Zanello
Lot No.
Block No.
QWindows/Doors
Roof
Building Height:
1-1
Root pitch
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: portstiucieplumbing@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:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: ,Not Applicable
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 your Notice of Commencement.
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Sign a of ner/ Lessee/Contractor as Agent for Owner
Signzit6of Con or/License Holder -
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF--
COUNTY OFA
The f�gfiin nstr nt was acknowledge beforeme
this a of t 20 b
The f� ing instr was acknowle2dg¢�l,bebfore me
this- • a of ZV y
Gary W. Zaneilo
Gary W_ Zanelio
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- da)
(Signature of Notary Public_ aarida) [JaMelleHiglin
COMMISSION #FMW01
FFsoFaoss Seal ?IRES:Augu3125.20a
=ic �►- COMMISSION lFFSO1O99
FF901099 ES: August 25, 2019
Commission No.
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Commission No. _ _ (SEI
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Rev. 8/2/17