HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/0812018
Permit dumber:
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
PERMIT APPLICATION FOR: plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 6 Lake Vista Trail 202
Legal Description: Vista St Lucie Building 6 Unit 202
Commercial Residential xx
Property Tax ID #: 3422-500-0079-000-4
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:
A rtlona wor to Mee
Orme un er t Is permitappy:
HVAC Gas Tank ❑Gas Piping _ Shutters
Electric Plumbing OSprinklers Generator
Total Sq. Ft of Construction: S. Ft. of First Floor: _
Cost of Construction: $ 900.00 Utilities:Sewer D Septic
OWNER/LESSEE:
Na me Michael Aspris
Address: 142 N Queens Ave
City: Massapequa NY
State:
Zip Code: 11758 Fax:
Phone No. 516 359-7668
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
El
Lot No,
Block No.
Windows/Doors
Roof Roof pitch
Building Height:
Name: GaryW Zanello
Company: Port St Lucie Plumbing
Address: 6907 Heritage Dr
City: Port St Lucie FI
State:_
Zip Code: 34952 Fax: 772 489-9126
Phone No. 772 468-6524
E -Mail: Portstfucieplumbing@gmaii.com
State or County License: CFC058025
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
COUNTY
F
�
O R Y G A
Permit dumber:
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
PERMIT APPLICATION FOR: plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 6 Lake Vista Trail 202
Legal Description: Vista St Lucie Building 6 Unit 202
Commercial Residential xx
Property Tax ID #: 3422-500-0079-000-4
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:
A rtlona wor to Mee
Orme un er t Is permitappy:
HVAC Gas Tank ❑Gas Piping _ Shutters
Electric Plumbing OSprinklers Generator
Total Sq. Ft of Construction: S. Ft. of First Floor: _
Cost of Construction: $ 900.00 Utilities:Sewer D Septic
OWNER/LESSEE:
Na me Michael Aspris
Address: 142 N Queens Ave
City: Massapequa NY
State:
Zip Code: 11758 Fax:
Phone No. 516 359-7668
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
El
Lot No,
Block No.
Windows/Doors
Roof Roof pitch
Building Height:
Name: GaryW Zanello
Company: Port St Lucie Plumbing
Address: 6907 Heritage Dr
City: Port St Lucie FI
State:_
Zip Code: 34952 Fax: 772 489-9126
Phone No. 772 468-6524
E -Mail: Portstfucieplumbing@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 TITLEHOLDER: 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 thepermit 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
commencine work or recordine your Notice of Commencement_
-Z -; v ;Z' 1, t Z/1
A�"o
Signatur f Cont or/License Holder
Signature/I Own r Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFA
COUNTY OF --
The forgoing instruppignt was acknowledged before me
this r7rlay o v 20 19 by
The f�rgoing instryiTent was acknowledged before me
this day OV �S
of .
of 20 by
Gary W_ 7anello
Gary W. Zaneno
Mame 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 S glia
u
� � = Danielle Biglin
COMMI55I674 IFF901
(Signature of Notary Public- i� o ridgy j EXPIRES: August 25.2
9 r5i nature of Nota N
01 g Notary Public- j E%PIRES: August 25, 2019
Commission No_ FF9014099 Seal) Y+ �MAARoNNoTARY_C
�-
Commission No. FF9014099 ''�_141111i��r�`` (Seal) t)AS
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17