HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: January 27, 2019 Permit Number:
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 X
PERMIT TYPE: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 9619 Enclave Cr Port St Lucie, FL 34986
Property Tax ID #: 3322-800-0019-000-0 Lot Na 16
Site Plan Name: Block No.
Project Name:
=DETAILED DESCRIPTION OF WORK:
Replace 75 gallon LP gas water heater (Like fo like)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit– check all that apply:
_Mechanical /Gas Tank _ Gas Piping Shutters Windows/Doors
_ Electric y Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction. $ 1,700.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Miriam Mayrides Name: Gary W. Zanello'
Address. -9619 Enclave Cr Company: Port St Lucie Plumbing
cc
City: Port St Lucie State: ,r,r Address: 6907 Heritage Dr
Zip Code: 34986 Fax: City: Port St Lucie State: FL
Phone No.908 209-0763 Zip Code: 34952 Fax: 772 489-9126
E -Mail: Phone No772 468-6524
Fill in fee simple Title Holder on next page ( if different E -Mail portstlucieplumbing@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.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address : 6907 Heritage Dr
City:
BONDING COMPANY: Not Applicable
Name:
Address:
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
commencing work or recording your Notice of Commencement.
of
STATE OF FLORIDA
COUNTY OF --
as Agent for Owner
The forgoing instru nt was acknowledged before me
this dZ-7 day of G! 20 I by
Gary W. Zamilo
Name of person making statement
Personally Known xx OR Produced Identification
Type of Identification
Produced
44avu-ili-V
(Signature of Notary Public, ' `.Florida } Daflielle lg if'
COMMISSION OM10"
Commission No. FF9o1099 'f (S&g jRES: August 25, 2419
V+ fww.AxRONNOTARY.tdM
2j, z'
Sign u of actor/License Holder
STATE OF FLORIDA
COUNTY OFSL-.io
Thefor oing instr ent was acknowledged before me
this i' _ day of LIg5itXq20A by
Gary W. Zanello
Name of person making statement
Personally Known xx OR Produced Identification
Type of Identification
Produced
&�- —Daniella Biglin
(Signature of Notary Puf�'li e�pFlori5514N ►FF901099
�� S: August 25, 2019
Commission No. FFsotoss ° t7f'iF�,' YEA &3TNOTARY.COM
7fllY %
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DATE
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Rev. 8/2/17