HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date- June 24, 2021
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 29 Lake Vista Trail 207 Port St Lucie, FL 34952
Property Tax ID #. 3422-500-0406-000-6
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Run hot and cold water lines overhead to utility room for washer hook-up.
Residential xx
Lot No.
Block No.
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
f_
— Electric V Plumbing _ Sprinklers
_
_ Generator Roof ' Pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction: $ 1,200.00 Utilities: Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Garner Southard
Name:Gary W Zanello
Address:29 Lake Vista Trail 207
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. 772 607-2709
Zip Code: 34952 Fax:
E-Mail:
Phone N0772 468-6524
Fill in fee simple Title Holder on next page ( if different
E-Mail portstlucieplumbing@gmail.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.
WARNING TO OWNER.
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMETWICE FOR
NT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.
IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Must by signed by owner/Agent and applicant:
(Signatur6prCantracOK
State of Florida, County of S1 L arc I e
Affirmed to and subscribed before me this �U /
c , 20 Z t' by CVr
personally known to me or wh6 has produced
as identification.
Notary Signature:
Notary (print name) An 1 E lle �
(Signature of Owner or Agent (including contractor))
State of Florida, County of
Affirmed to and subscribed before me this
2a ,by
personally known to me or who has produced
of Si4GG31
A 2Q
B�I�Fd6d Th hm
Notary (print name)_
Construction documents must accompany this application. The Florida energy code submitted becomes an integral part of this
plan and must pass final inspection. "Notice: In addition to the requirements of this permit, there may be additional restrictions
applicable to this property that may be found in the public record of this county, and there may be additional permits required
from other governmental entities such as waste management district, state agencies, or federal agencies. "SIGNATURE OF THE
APPLICANT MUST BE NOTARIZED. If owner builder, applicant must sign in person. BUILDING PERMIT includes:
Building, Electrical, Plumbing, Mechanical, and Sewer only. All other trades require separate applications.
Asbestos compliance: It is the owner's or operator's responsibility to comply with section 469.003, Florida Statutes, and
to notify the Department of Environmental Protection of his or her intentions to remove asbestos, when applicable, in
accordance with state and federal law.
FEE SIMPLE TITLEHOLDER, BONDING COMPANY AND MORTGAGE LENDER INFORMATION IS REQUIRED WHEN
THE AGGREGATE VALUE (TOTAL COST OF ALL IMPROVEMENTS AND NOT JUST WORK AUTHORIZED BY THE
INDIVIDUAL PERMIT) IS $2500 OR MORE (EXCEPT HVAC REPAIR/REPLACEMENT< $7500). PLEASE ADDRESS ALL
ITEMS.
Fee Simple Titleholder's
Name (if other than owner):
Address:
City;
❑ Same as Owner
State: Zip:
Bonding Company ❑ Not Applicable
Name.• _
Address:
City:
State: Zip:
Mortgage Leader's 0 Not Applicable
Name:
Address:
City: State Zap:
OFFICE USE ONLY
Is the property located in a Special Flood Hazard Area (tloodplain) per the current Flood Insurance Rate Map (FIRM)
❑ Yes ❑ No
Flood Zone: Reviewed by: Determination:
Permit Fee
State Surcharge
Subcontractor
Total Amount Due at Issuance
Remarks
Other $
Other $
Flood Review Fee $
S
Plan Review Fee
Routing Fee $
Other S
E
de Violation ❑ Yes ❑ No
Reviewed by Date Final Check __ Date
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