HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 06/04/2020
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 28 Lake Vista Trail 101 Port St Lucie, FL 34952
Property Tax ID #: 3422-500-0379-000-7
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace 30 gallon electric water heater (Like for like)
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit –check all that apply:
Residential xx
Lot No.
Block No.
Mechanical — Gas Tante —Gas Piping � Shutters Windows/Doors Pond
Electric V Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq., t of Construction:
Cost of Construction. $ 95D.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Virginia Fossaceca
Name: Gary W Zanello
Address: 28 Lake Vista Trail 101
City: Port St Lucie FL State:
Zip Code: 34952 Fax:
Phone No.772 871-6469
Company: Port St Lucie Plumbing
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 portstiucieplumbing@gmail.com
State or County LicenseCFC058025
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone.
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
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 Oft 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."
SignatuAW-
Twwbw n essee Con rector as Agent for Owner
5ignatu e Con or/License older
STA 41EX00F FLORIDA
STATE OF FLORIDA
COUNTY OF St Lucie
COUNTY 0FstLucie
The for ping instrument as acknowledged before me
this day 20 26 by
The forging instrumen as acknowledged before me
this day 20 2�O by
of fes,
e " of
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'Mentification
Type of Identification
Type of Identification
Produced _
Produced ' D�HB� oft
le
DanisB'
On ' . Comm. I GG3�A658
Comm.*GG3
0817. E)MkU 25.20xAnnft
(Signature of Notary lic- State , '� 0;1BUM&Wd
Wyature of Notary ublic- State --df lorida )
Commission No. GG360658 (Seal)
Commission No. GG360658 (Seal)
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