HomeMy WebLinkAboutBuildilng Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/25/2019
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:
Permit Number:
Building Permit Application
Commercial Residential xx
Address: 27 Lake Vista Trail 204 Port St Lucie, FL 34952
Property Tax ID #: 3422-500-0375-000-9
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace 30 gallon electric water heater (Like for Like)
LCONSTRUCTION INFORMATION:
Additional work to be performed under this permit– check all that apply:
_Mechanical ` _ Gas Tank _ Gas Piping _ Shutters
— Electric / Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 950.00
Lot No.
Block No.
Windows/Doors
Generator _ Roof
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
Namelgeno DeSilva
Name: Gary W. Zanello `
Address: 27 Lake Vista Trail 204
Company:Port St Lucie Plumbing
City: Port St Lucie State:
Zip Code: 34952 Fax:
Phone No.
Address:6907 Heritage Dr
City: Port St Lucie State: FL
Zip Code: 34952 Fax: 772 489-9126
Phone N0772 468-6524
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail portstlucieplumbing@gmail.com
State or County License CFC058025
It value of construction is SZ5UU 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 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 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 Horne 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.
Signatu Owner ssee/C ntractor as Agent for Owner
Asigna nt -a icense oder
STATE OF FLORIDA
STATE OF FLOR A
COUNTY OFstLucie
COUNTY 0FsLL de
for
The for oing instrume t was acknowledged before me
'
The forgoing instrument wasacknowledged before me
thiso of 20� by
this � y of f /��� 20 /9 by
Gary W_ Zanello
Gary W. Zanelia
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
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FRONT
ZONING
SUPERVISOR
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MANGROVE
COUNTER
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DATE
RECEIVED
DATE
COMPLETED
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