HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: July 17, 2019 Permit Number:
COUNTY
F L O R 1 0 A
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
PERMITTYPE:PIumbing
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential xx
Address: 23 Lake Vista Trail 201 Port St Lucie, FL 34952
Property Tax ID #t: 3422-500-0316-000-8
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace 30 gallon electric water heater (like for like)
CONSTRUCTION INFORMATION:
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
Total Sq. Ft of Construction: _
Cost of Construction: $ 900.00
Generator Roof
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
NameSusan Burt
Name: Gary VV. Zanello'
Address:23 Lake Vista Trail 201
Company: Port St Lucie Plumbing
City: Port St Lucie State:
Zip Code: 34952 Fax:
Phone No.347 531-8370
Address:6907 Heritage Dr
City: Port St 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 partstlucieplumbing@gmail.com
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.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City:
Zip:
Phone
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:_
Address:
City: _
Zip:
Phone:
State:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
_X� 711 Z�V
Signat O Lessee/Contractor as Agent for Owner
Sign of racto-O cense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFst. Lucie
COUNTY OF St- Lucie
The forgoing instrument was acknowledged. before me
The forgoing instrument was acknowledged before me
this th, day of July- 20_ by
this-161. day of July 20_ by
U(A r v �4 ZQ re «o
( � � _-ZZA_
Name of pe on making statement.
Name a 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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Commission No. FF901099 (Seal{
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