HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: March 23, 2021 Permit Number:
9Uo[LUC l5 `
P b Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential XX
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 22 Lake Vista Trail 106 Port St Lucie, FL 34952
Property Tax ID#: 3422-500-0300-00013 Lot No
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace drain and shower pan in master bathroom
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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: Sq. Ft. of First Floor:
Cost of Construction: $ 350.00 Utilities: -Sewer _Septic Building Height:
OWNERAESSEE: CONTRACTOR:
NameAndre Beauchesne Name: Gary Zanello
Address:22 Lake Vista Trail 106 Company:Port St Lucie Plumbing
City: Port St Lucie FL State:_ Address:6907 Heritage Dr
Zip Code: 34952 Fax: City: Port St Lucie State: FL
Phone No.819 244-4944 Zip Code: 34952 Fax:
E-Mail: Phone No 772 468-6524
Fill in fee simple Title Holder on next page(if different E-Mail portstlucieplumbing@gmaii.com
from the Owner listed above) 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 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.
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 commencin work or recordin our Notice of Commencement.
Sign u of r/Lessee/Contractor as Agent for Owner Sig ntractorJLicense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST.LUCIE COUNTY OF ST.LUCIE
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Prese ce or Online Notarization
this�3 dayof / CI"C - 202 f by this day of kA— 2021 by
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 Identification
Type of Identification Type of Identification
Produced Produced
DanWe ftgn
(Signature of Notary Publi_,� o _ridUmm.#GG3 58 (Signature of Nota� �011�•i�
Commission No. cGssass$ y =:ALVist 25,202ThruAm ommission No. oGasas
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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