HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/31/2019 Permit Number:
- ?Jr_
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 Commercial Residential xx
PERMITTYPE=Permit
PROPOSED IMPROVEMENT LOCATION:
Address: 9522 Shadow Ln Ft. Pierce, FL
Property Tax ID #: 1334-502-0111-000-1
Site Plan Name:
Project Name:
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I
Replace 50 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 Windows/Doors
Electric Plumbing _ Sprinklers ^ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 950.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Robert Orr
Address:9522 Shadow Lane
Name: Gary W Zanello
Company.Part St Lucie Plumbing
City: Ft. Pierce State: ; =-
Zip Code: 34951 Fax:
Phone No.717 327-0012
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 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
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
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 Nome 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 YOU)t NOTICE OF COMMENCEMENT_"
as Agent for Owner
STATE OF FLORIDA
COUNTY OFst. L-cie
The forgoing instrument was acknowledged before me
this. / _ day of �e, 20 19 by
Gary W. Zanello
Name of person making statement.
Personally Known xx OR Produced Identification
Type of Identification
Produced
(Signature of Notary Piv((blic- 3t F. �°1-r lwvlj
Commission No. GG360658�I
STATE OF FLORIDA
COUNTY OFsr_s_.Ge
The for
s}*€ping instrument was acknowledged before me
this-? i . day of 20 by
Gary W. Zanello
Name of person making statement.
Personally Known xx OR Produced identification
Type of Identification
Produced
Dwiek Bigiin
(Signature of Not a `��2 , 2023
blOmmission No_ GG36Oss8 ' ` Sea �1�"-"" M
FRONT
ZONING
SUPERVISOR
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VEGETATION
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MANGROVE
COUNTER
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DATE
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Rev_ 2/7/ 19