HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/14/2019 'Permit Number:
i
rXIS l N?
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
PERMIT TYPE:Plumbing
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential xx
Address: 9 Lake Vista Trail 106 Port St Lucie FL 34952
Property Tax ID #: 3422-500-0118-000-0
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Reploace 30 gallon electric water heater (like for like)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check ail that apply:
_Mechanical Gas Tank Gas Piping _ Shutters
Electric / Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 900.00
Generator
Sq. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors
Roof
Utilities: Sewer _Septic Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name Bruce Burris
Name: Gary W. Zanello
Address:292 Arlington St
Company: Port St Lucie Plumbing
City: Mineola State: "7-
Zip Code: 11501 Fax: T
Phone No.516 808-5521
Address:6907 Heritage Dr
City: Port 5t Lucie State: FL
Zip Code: 34952 Fax: 772 489-9126
Phone No 772 468-6524
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail portstiucieplumbing@gmail.com
State or County LicenseCFC058025
If value of construction is $2500 or more, a RECORDED Notice or COmmencement is requirea.
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: _I
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 commented prier 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.
�ignatu(A Owner ssee/C ntractor as Agent for Owner
Signatur of ntra i c e n s e- o der
STATE OF FLORIDA
STATE OF FLOR A
COUNTY OFst W -e
COUNTY 0FsLLude
The forgoing instru e was acknowledged before me
1 f6
The for ing instrynj ent as acknowledged before me
this day of 20 by
this` day of N rCr7 20/Q by
Gary W_ Zanelio
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
u III/
?.P6,��% Danielle Biglin
Danielle Win
MISSION IFMI099
COMMISSION #FR01099
{Signature of Notary Pu .- —da) EXPIh S: August D.
(Signature of Notary Pu 'Flan ' 0 ,
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Commission No. FF901089(Seal) \4
Commission No. FF901099 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev - 9/26/18