HomeMy WebLinkAboutBUILDING PERMIT All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: February 07, 2019 Permit Number:
s
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 XX Residential
PERMITTYPE:Plumbing
PROPOSED INPROVEMENT LOCATION:
Address: 18 Lake Vista Trail 104 Port St Lucie, FL 34952
Property Tax ID#: 3422-500-0242-000-8 Lot No.
Site Plan Name: Block No.
Project Name:
FDETAILED DESCRIPTION OF WORK:
Replace 30 gALLON ELECTRIC WATER HEATER (like for like)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
Mechanical /Gas Tank _Gas Piping _Shutters ,Windows/Doors
Electric ✓ Plumbing _Sprinklers Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 900.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Phyllis Gauger Name:Gary W Zanello
Address:14482 Autumn Ave Company:Port St Lucie Plumbing
City: Wellington State:, Address:6907 Heritage Dr.
Zip Code: 33414 Fax: City: Port St Lucie State:FL
Phone No.561 386-9494 Zip Code: 34952 Fax:
E-Mail: phone No 772 468-6524
Fill in fee simple Title Holder on next page(if different E-Mail portstlucieplumbing@gmail.com
from the Owner listed above) State or County LicenseCFC058025
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 MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City. State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: ____Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the worts 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 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,l do hereby agree that I will,in all respects,perform the worts
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
commencinR work or recording our Notice of Commencement.
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Signatu Owner ssee/C ntractor as Agent for Owner Signatur of ntra icense o der
STATE OF FLORIDA STATE OF FLOR A
COUNTY OFst Lucie COUNTY OFst Dole
The f%gong instru7erg was acknowledged before me The fo[going instr m t was acknowledged before me
this . day of 20Lq by this: ,..,- day of 20/i by
Gary W_Zanallo Gary W.Zanello
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
� r ,
Danielle Qiglln
�. I3etliElle Biglin
MISSION IFF9010M OOMMiSSWN #Ff901o99
(Signature of Notary Pu ida]EXPIRES,August (Signature of Notary Pu � Flori si
WWW.AARGNNOTARY:GGM .,f #''' .�� WWW:MRONNOTARY.COM
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Commission No. FF901099 (Seal) Commission No. FF9G1099 (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
BUILDING &CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
�r FORT PIERCE, FL 34982
® - 772-462-1553
•<; ' ,� ;`-Y; FAX 772-462-1578
AUTHORIZATION FORM FOR CREDIT CARD PAYMENT
TO: St Lucie County
RE: 18 Lake Vista Trail Port St Lucie Ld
Permit #
Credit Card Users: 1.5°fo .Surcharge added per transaction.
Payments must be received in this department by 4:00 PM for transaction to be
processed that day, if not it will be processed the following business day.
X VISA MASTERCARD
Credit Card Number 4339-9315-7515-6682
Expiration Date 07119 Zip Code 34952
3 digit security code 225
Amount $159-00 + 1.5% surcharge
Business Name: Port St Lucie Plumbing
Authorized Signature:
Print Name: Dolores Zariello
Phone: (772 ) 468 _ 6526
Fax: 772 ) 489 _ 9126
Comments:
SLCPDSD Revised 4/01/2010 EN