HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03!1012018
7- VNTY
YEw
F L O R I D A
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-IS53 Fax: (772) 462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 6040 lndrio Rd T-2 Ft. Pierce, FL
Legal Description: Indian Pines Village Building T Unit 2
Property Tax ID #: 1313-501-0144-000-3
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.
CONSTRUCTION INFORMATION:
Additional work to b
erformed under this permit — c� appy:
LJnHVAC L� Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
11 Electric Plumbing ❑ Sprinklers Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 900.00
Sq. Ft. of First Floor: _
Utilities: Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Robert Turner
Name: Gary W. Zanello
Address: 19403 Dans Rock Rd
Company: Port St Lucie Plumbing
City: Frostburg State:MD
Zip Code: 21532 Fax:
Phone No.Sallie 772 672-4573
Address: 6907 Heritage Dr
City: Port St Lucie State: FL
Zip Code: 34952 Fax: 772 439-9126
Phone No. 772 468-6524
E -Mail:
Fill in fee simple Title Bolder on next page ( if different
from the Owner listed above)
E -Mail: portstlucieplumbing c@gmail.com
State or County License: CFC058025
If value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN 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, 1 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
9WA49
Sign of e of ner/ Lessee/Contractor as Agent for Owner
Sign of C106 rAicenseHalder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF-L.d.
COUNTY OF --
The far Ding instrument was acknowledged before me
(&
The forgoing instalment _ as acknowledged before me
r�
this day of 20 by
this of ii ST 20 by
GaryW_ Zanello
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- da)
(Signature of Notary Public- i,�F�orida) Uamelle Biglin
COMMISSION #FF901
Commission No. FF9014099 -. Seal EXPMES: Aupiist25, 2'M
�•� '' 1099
COMMISSION #FF"
Commission 7►� ES: Aqua 25, 2019
Commission No. (SSI '�
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Rev. 8/2/17