HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: October 05, 2018 Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial XX Residential
PERMIT APPLICATION FOR: Plumbing l
PROPOSED IMPROVEMENT LOCATION:
Address: 1313 W. Midway Rd. Ft_ Pierce, FL
Legal Description: White City Black 73
Property Tax ID #: 3404-501-0428-000/3
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side:
Replace 40 gallon electric water heater (like for like)
Left Side:
Lot No.—
Block No.
CONSTRUCTION INFORMATION:
Additional work toe pertormed un ert ispermit–check all appy:
HVAC Gas Tank OGas Piping _ Shutters Windows/Doors
11 Electric 21 Plumbing Sprinklers L _I Generator 0 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 850-00
SFt. of First Floor:
Utilities: Sewer E] Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 1313 Midway LLC
Name: Gary W. Zanello
Company: Port St Lucie Plumbing
Address: 13100 Park Bud, Ste B
City: Seminole State: FL
Zip Code: 33776 Fax:
Phone No -727 692-1008
E -Mail:
Address: 6907 Heritage Dr
City: Port St Lucie State: FL
Zip Code: 34952 Fax: 772 489-9126
Phone No. 772 468-6524
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 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 Count 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 Godes 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
commencinla work or recording vour Notice of Commencement_
IL4- -;t/ &d
ZZLO 17
Signatur f Contr or/License Holder
Signature f Own r essee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFA--
COUNTY OFn —
The forgoing instrt�Mme�jnt was acknowledged before me
The forgoing instru e t was acknowledged before me
this t/+ day of UG7
20 by
thi5't f�tday of Z� 20_ by
Gary W. 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
Danielle Biglln
/ IJ ,,/1 "Er Danielle Blellli
CommiSSION #FF901
Signature of {Votary Public- i o r j WIRES: Aelgust 25,2113
Signature
g tore of Notary Public- {'��fda) EXPIRES: Atlgust 25, 2019
www.AARONN0TARyA Commission No. flii1eall
[ommission No. FF9014099 ! e AARONNDTARy.COi
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