HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: September 04, 201Q
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: 9004 Short Chip Cr Port St Lucie
Legal Description: Lakes at PGA Village Block D Lot 43
Property Tax ID #: 3334-501-0181-000-5
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side
Replace 50 gallon electric water heater (like for like)
Left Side:
Lot No.43
Block No. D
CONSTRUCTION INFORMATION: e
Acid iti onal work to be nertorme under this permit— check all that apply:
HVAC Gas Tank Gas Piping _ Shutters Windows/Doors
Electric L"_l Plumbing Sprinklers Generator ® Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 900.00
SFt. of First Floor: _
Utilities:'n Sewer _ Septic
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
NameAlexander Cortez
Name: Gary W Zanello
Address.171 Stone Hill Rd
Company: Port St Lucie Plumbing
City: Colts Neck State:NJ
Zip Code: 07722 Fax:
Phone No.772 475-3867
Address: 6907 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@gmail.com
State or County License: CFC058025
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIED LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: 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 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
its accordance with the approved plans, the Florida Sudding Codes and 5t. 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 nun -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 pasted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commOncine warp or recordine vour Notice of Commencement.
/fJfI
1PJV_ 'A' 0,
-
Signrof er/ Lessee/Contractor as Agent for Owner
Si ECi f Co� or/License Molder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF--
COUNTY OF--
The forgoing instru ent s acknowledge before me
this day of _, 20 / by
The f r Ing instru nt v s ackno�fledge#�,before me
this day of , 20 by
C,WY r.zffAft
C.Urw-zwwiab
Name of person making statement
Name of person making s Cement
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of identification
Type of Identification
Produced
Produced
+
J6,z�_7&, ,
(Signature of Notary Public "i'1r7 Oa) Danielle lilglin (Signature of Notary Puba I Flori
- COMMISSION 9FF9919 ��c �e XPIRE& ION 1fF9Oi419
Commission No. FF9094099 - J al EXPIRES: August 2S. 2 FROM9 .` E%PERES: A NOTgul RY 24 m
' ) $ �amrsaiss'ran No. •, ••...• r I+i®TARY.COM
1N M.AARONNOTARY. M
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SFATURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev- 8/2/17