HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Nov. 11, 2020 Permit Number:
l.�r c c W c c t;L Building Permit Application
Planning and Development Services
Building and Code Regulotion Division Commercial Residential XX
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FORplumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 8904 Champions Way Port St Lucie FL 34986
Property Tax ID #: 3334-501-0069-000-4
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace 50 gallon electric water heater (Like for like)
New Electrical Meter Second Electrical Meter
Lot No. —
Block No.
I CONSTRUCTION INFORMATION: i
Additional work to be performed under this permit —check all that apply:
_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:
Name Richard Fairley
Name: Gary W Zanello
Address:8904 Champions Way
Company: Port St Lucie Plumbing
City: Port St Lucie FL State: _
Zip Code: 34986 Fax:
Phone No.860 490-4528
Address:6907 Heritage Dr
City: Port St Lucie State: FL
Zip Code: 34952 Fax: 772 489-9126
Phone No772 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 Z5D0 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 I%nder or an attorney before commencing work or recording your Notice of Commencement.
as Agent for Owner
STATE OF FLORIDA
COUNTY OFstLu6e
Sworn to (or affirmed) and subscribed before me of
Physical Pres ce or Online Notarization
thiday of py frA 2020 by
Gary VV zanello
Name of person making statement.
Personally Known xx OR Produced Identification
Type of identification
Produced
(Signature of Notary Pu f Flo
z Comm.80365s
Commission No. GG360651tU; E*i lA 25, �23
�; ` BIAW ft Aeon Notary
rise Holder
STATE OF FLORIDA
COUNTY OFstLucie
Sworn to (or affirmed) and subscribed before me of
Physical Pre ce or Online Notarization
this Y_ day of 47/�1772 1C , 2020 by
Gary W Zanello
Name of person making statement.
Personally Known xx OR Produced Identification
Type of Identification
Produced(}}
(Signature of N c- Sta4g�"gun
Gamin, i� GG3S0658
Commission Nc �G $= • A)
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Rev. 5