HomeMy WebLinkAboutBuilding Permit Application Dec 1718 02:47p Po' rt St.Lucie PlumbingH 772 489-9126 P.1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: I&T12_019 4 .
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Building Permit Applicatior DEC 182018
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial xx Residential
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
-Address: 29 Lake Vista Trail 106 Port St Lucie,FL 34952
Legal Description: Vista St.Lucie Building 29 Unit 106
Property Tax ID 3422-500-0398-0006 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace 30 gallon electric water heater,(Like for Like)
CONSTRUCTION INFORMATION:
Additional work to bp,nartormed under this permit–check all=appy:
L�IHVAC Gas Tank F]Gas Piping Shutters Windows/Doors
FPlumbing F]Sprinklers
Electric' FV FIGenerator _F Roof' Roof pitch
Total Sq.Ft of Construction: SQ_ Ft-of First Floor:
Cost of Construction:$ 900.00 Utilities: Sewer I jSeptic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Richard King Name: Gary WZanellb
Address-.15 Lake Vista Trail 102 Company: Port St Lucie Plumbing
City: Port St Lucie State:FL Address: 6907 Heritage Dr
Zip Code: 34952 Fax: city. Port St Lucie state-FL
Phone No.249-4343 Donna Chandler Zip Code: 34952 Fax: 772 489-9126
E-Mail- Phone No. 772 468-6524
Fill in fee simple Tide Holder on next page if different E-Mail: portstiucieplumbing@gmaii.com
from the Owner listed above) State or County License: CFC058025
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Dec 1718O2:47p Port St,Luci77248Q-D120 p
Lucie .2
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERANGINEER: 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:
Add ress:60-0-f Heritge Or 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 B 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,per-form 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
ornmencing work or recording your Notice of Commencement.
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Signature of 61ner/��6ee/Contractor as Agent for Owner Signature olontr�cloy!cerise Holder
STATE OF FLORIDA STATE OF FLORIDA/
COUNTY OF.— COUNTY OF-,-
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 'Ah day of December 20 by this 17111 day of Decem— 20_ by
Name of person making statement Name of person making statement
Personally Known xx OR Produced Identification Personally Known xx OR Produced Identification
Type of Identification Type of Identification
Produced Produced
IL
(Signature of Notary P FlorWlil ISSION #FFRIM (Signature of Notary Pu@gE FlorJM(XUAu2t:2S.2M"9
EXP E$.AUWM25,2019
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