HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: October 10, 2019 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
.2300 Virginia Avenue, Fort Pierce FL 3498.2
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xx
PERMITTYPE:Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 22 Lake Vista Trail 201 Port St. Lucie, FL 34986
Property Tax ID #: 3422-500-0302-000-7
Site Plan Name:
Project Name:
DETAILED 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
Electric J Plumbing —Sprinklers _ Generator
Total Sq. Ft of Construction: _
Cost of Construction: $ 900A0
Sq. Ft. of First Floor: _
Lot No._
Block No.
Windows/Doors
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Raymond Schloss
Name: Gary W. Zanello
Address:22 Lake Vista Trail 201
Company: Port St Lucie Plumbing
City: Port St Lucie State:
Zip Code: 34952 Fax:
Phone No.772 812-7476
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 portstlucieplumbing@gmail.com
State or County LicenseCFC058025
It value of construction is 5Z500 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:_
Address:
City:
Zip:
Phone
Name:
Address:
State: City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
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 1 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."
ign ur f wn ssee ontractor as Agent for Owner
S-1gnatkare f o or/ Llcens older
i
ST E OF FLORIDA
STATE OF FLORIDA
COUNTY 0Fst,uxi-
COUNTY OFSt. cud.
The forgoing instru e t vias acknowledged before me
The forgoing instrtAmwt
as acknowledged before me
this 1Q day of _p 2D� by
this day of p
r 201,9 by
Gary W. Zanello
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
Danieae B' in
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Daniek Bighn
(signature of Notary P lic-t F��ummm-'"i�,� ,�
(Signature of Not
Commission No. GGssasSs ,_- -
commission No. csssosss
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Rev. 9