HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/29/2021 Permit Number:
1�r
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Building Permit Application
Planning and Development Services
Building and code Regulation Division
2300 Virginia Avenue, Port Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
PERMIT APPLICATION 1OR:Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 12 Lake Vista Trail 204 Port St Lucie, FL 34952
Property Tax I #: 3422-500-0165-000-4
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:
Residential xx
Lot No.
Block No.
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: $ 1,000.00 Utilities: _Sewer _ Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Vito Cannavo
Name: Gary W Zanello
Address:373 SW Ray Ave
Company: Port 5t Lucie Plumbing
City: Port St Lucie FL State: Address: 6907 Heritage Dr
Zip Code: 34983 Fax: City: Port St Lucie State: FL
Phone No. 772 349-1168 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@gmail.com
from the Owner listed above) State or County License CFC058025
If value of construr_tinn is 7rnn nr mnrn � ocrnnncn
la ic4ulmu.
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 TWICE FOR
0WROVEMENTS TO YOUR PROPERTY, A NOTICE OF COMMENCEMENT 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:
(Signatur�cdntrac
State of Florida, County of S� L kC iel
Affirmed to and subscribed before me this1,�rUOZ ft 20 Z / by (fir W Zil O
personally known to me or wh has produced
as identification.
Notary Signature:
Notary (print name) 1 lilB��Pi 1
(Signature of Owner or Agent (including contractor))
State of Florida, County of
Affirmed to and subscribed before me this
20----, by
Personalty known to me or who has produced
Si JAG
ivos: August gGilydNAal0i1�
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. AH 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
INDIVIDUAL THE AGGREGATE VALUE (TOTAL COST OF ALL IMPROVEMENTS AND NOT JUST WORK AUTHORWED BYINDIVIDUAL PERMIT) IS $25011 DR MORE THE ITEMS. (EXCEPT IIVAC REPAIR/REPLACEMENT< $7500). PLEASE ADDRESS ALL
Fee Simple Titleholder's
Name (if other than owner):
Address:
City;
❑ Same as Owncr
State: ,zip:
Mortgage Lender's ❑ Not Applicable
Name-
Bonding Company ❑ Not Applicable
Name: _
Address;
City:
State zip:
Address:
City: State zip -
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
Plan Review Fee
Routing Fee
$ Other $
Active Code Violation ❑ Yes ❑ No
Case #
Case Type
Reviewed by
Date
Final Check
Date
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