HomeMy WebLinkAboutbuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: February 14, 2019 Permit Number:
NTY
L O R I D A
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
PERMITTYPE:Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 8393 Mulligan Cr. Port St. Lucie, FL
Property Tax ID #k: 3327-502-0231-000-2
Site Plan Name:
Project Name: _
DETAILED DESCRIPTION OF WORK:
Replace 40 gallon electric water heater (like for like)
CONSTRUCTION INFORMATION:
Commercial Residential XX
Lot No._
Block No.
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: _
Cost of Construction: $ 950.00
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name George Bishop
Name: Gary W. Zanello
Company: Port St Lucie Plumbing
Address:68 Via Del Corso
City: palm Beach Gardens State:.
Zip Code: 33418 Fax:
Phone No.607 761-7144 Jeannie Adams
Address:6907 Heritage Dr
City: Port St Lucie State: FL
Zip Code: 84952 Fax: 772 489-9126
Phone No772 468-6524
E -Mail:
Fill in fee simple Title Halder on next page { if different
from the Owner listed above)
E -Mail portstlucieplumbing@gmail.com
I
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 TITLE HOLDER: _ 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 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 Aermit 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
commencinpa work or recordiniz your Notice of Commencement.
ILI /� �LAV
Signatu POWne 2�Kssee/CcYntiactor as Agent for Owner
'913
Signatur of ntra icense oder
STATE OF FLORIDA
STATE OF FLOR A
COUNTY OFst-L-A
COUNTY OFs-cucie
The forgoing tristrurngnt was acknowledged before me
1'l1Qf
The fRorgoing instrup3eqt was acknowledged before me
this day of 20L9� by
tl day of 1-61vf . l r 201? by
Gary W_ Zane[lo
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
Danielle Biglin
' fi `'�.�.r �' ', Danielle 9411i I
}"MMMISSION IFF901694
CCOMMISSION>;FF90t999
(Signature of Notary Pu ` - w ida) EXPIRE& August 25- 2019(Signature
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Commission No_ FF901099 (Seal)
Commission No. FF901099
(Seal)
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FRONT
ZONING
SUPERVISOR
PLANS
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REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev. 9i2bi18