HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/03f2O2O 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: 21 Lake Vista Trail 104 Port St Lucie, FL 34952
Property Tax ID #: 3422-500-0284-000-4
Site Plan Name:
Project Name:
I DETAILED DESCRIPTION OF WORK:
Replace 30 gallon electric water heater (Like for like
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential xx
Lot No._
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ WindowVDoors _ Pond
— Electric / Plumbing —Sprinklers _ Generator _ Roof Pitch
Total Sq., Ft of Construction:
Cost of Construction: $ 950.00
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Nina Ibarra
Address:21 Lake Vista Trail 104
Name: Gary W Zanello_ _
Company: Port St Lucie Plumbing
City: Port St Lucie FL State: _
Zip Code: 34952 Fax:
Phone No. 772 206-6431
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
State or County License CFC058025
It 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
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: 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 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County 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 our Notice of Commencement.
Signs r # O { Le ontractor as Agent for Owner
Signat ontr /Lice e H der
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF SL Lucie
COUNTY O F St Lucie
a
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence ,or Online Notarization
this 3 day of lr 2020 by
Physical Presence or Online Notarization
this __-'? day of 12020 by
Gary W Zanelb
Gary W Zanello
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produeedd(/`/}I�
�)
un
(Signature of Notary Public- a lorlda)
DanieNe Biglin
Commission No_ GG36058 & 103606584mm155lon
:A*M25,206
{Signature of Notary P _ o- _ f FI
: • �
NO. GG360658 ?w5, 2023
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