HomeMy WebLinkAbout29-103All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Nov 03, 2020 Permit Number:
�F, LUL L '
L L C h L, tz - 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) 452-1578
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 29 Lake Vista Trail 103 Port St Lucie, FL 34952
Property Tax I D #: 3422-500-0395-000-5
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
IM00
Block No.
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors 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:
NameJames Golinsky
Name: Gary W Zanello
Address:29 Lake Vista Trail 103
Company: Port St Lucie Plumbing
City: Port St Lucie FL State: _
Zip Code: 34952 Fax:
Phone No. 772 359-0912
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@gmaii.com
State or County License CFC058025
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:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 your Notice of Commencement.
as Agent for Owner
STATE OF FLORIDA
COUNTY 0FStLucle.
Sworn to (or affirmed) and subscribed before me of
P ysical Pres ce or Online Notarization
this day of 2020 by
Gary W Zanello
Name of person making statement.
Personally Known xx OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pus MA4
f FlorUMMO 0191111
j�/��{ W.ly�GO±G3S �J$
� VY7nlil.
Commission No. GGssoss ?F .,,u,d25,
e BOilded ft Ill Nftry
Z944��
Signatu e Co ctor/License Holder
STATE OF FLORIDA
COUNTY 0FStLucia
Sworn to (or affirmed) and subscribed before me of
Physical Prece or Online Notarization
this L �day of Lrv'✓rn 2020 by
I Gary W Zanello
Name of person making statement.
Personally Known xx OR Produced Identification
Type of Identification
Produced
(Signature of Nc- Sta n
s Calm #GG360668
Commission Nci< G= ; A*d0,)
� 90E1ded ft Assn Notary
fnirit `
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20