HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01109/2019 Permit Number:
S - 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 0
PROPOSED IMPROVEMENT LOCATION:
Address: 5704 Palm Dr Ft. Pierce, FL 34982
Legal Description: Indian River Estates Unit 8 Block 62 Lot 5
Property Tax I #: 3402-609-0363-000-4
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Run new hot and cold water line overhead to bathroom and washing machine
Lot No.5
Block No. 62
Haaitionai worK to oe ertormea under tnis permit—cnecK allapply:
HVAC _ Gas Tank QGas Piping _ Shutters Q Windows/boors
11 Electric ® Plumbing Sprinklers 1:1 Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 2300.00 Utilities: Sewer ] Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Joan Baumberger
Name: Gary W. Zanello
Address:5704 Palm Dr
Company: Port St Lucie Plumbing
City: Ft Pierce State:FL
Zip Code: 34982 Fax:
Phone No. 772 468-9276
Address: 6907 Heritage Dr
City: Port St Lucie State: FL
Zip Cade: 34952 Fax: 772 489-9126
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@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:
City: State:
Zip: Phone:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address: 6907 Heritage D,
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.
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
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 your Notice of Commencement.
of
STA`iE OF FLORIDA
COUNTY OF --
as Agent for Owner
The Xdayof_
ing inst ent was acknowledged efore me
this o 20 by
Gary W. Zanello
Name of person making statement
Personally Known xx OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public-, ` r, E�orida ) Dal tEIle Biglin
COMMISSION IFF901M
Commission No. FFOOID99 .+C 'F (S �tRE5:l1Lcg:'st25.2fli9
. Ati WWW AAR0IUNOTARY.00M
1, // 2,1 Z - z 4 �
Sign u of actor/License Holder
STATE OF FLORIDA
COUNTY OF ---
The f r ging instr ent was acknowledged before me
this' day of20 by
Gary W. Zanello
Name of person making statement
Personally Known xx OR Produced Identification
Type of Identification
Produced
_JffAZ_iae; u 1 Daili a Bitglin
(Signature of Notary Pue�@tl"Ioria ISSION #FF9010"
s - S: August 25.2019
Commission No. FF901099
uum
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17