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HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: July 29, 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 101 Port St Lucie, FI 34952 Property Tax I D #: 3422-500-0393-000-1 Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: Replace tub and single handle shower valve in hall bathroom (Like for like) New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Residential X 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: $ 1,200.00 Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Steven Oostdyk Name: Gary W Zanello Address:29 Lake Vista Trail 101 Company: Port St Lucie Plumbing City: Pori St Lucie FL State: _ Address:6907 Heritage Dr Zip Code: 34952 Fax: Port St Lucie City: State: FL Phone No. 772 577-9322 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 LicenseCFC058025 If value of rnn%tri ir-tinn is 7snn nr ........ ocrnnn .., is requirea. 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 IMPROVEMENTS 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 bI signed by owner/Agent and applicant: (Signaturc�ntrac State of Florida, County of L 5� uC l e/ Affirmed to and subscribed ``��before J-me this Vr %y f. , 20 Z I by t? W Z! e O personally known to me or wh6 has produced as identification. Notary Signature: Notary (print name) Aait�� (Sigtlature of Owner or Agent (including contractor)) State of Florida, County of Affirmed to and subscribed before me this 20 , by personally known to me or who has produced otty sigrfamA GGA k; :i►prrs: Aug* 21 Booded T1NAm 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 TITLEHOLDEJ,BONDING COMPANY AND MORTGAGE LENDER INFORMATION IS REQUIRED WHEN THE AGGREGATE VALUE (TOTAL COST OF ALL IMPROVEMENTS AND NOT .LUST WORK AUTHORIZED BY THE INDIVIDUAL PERMIT) IS $2500 OR MORE (EXCEPT HVAC REPAIWREPLACEMENT< $7500). PLEASE ADDRESS ALL ITEMS. Fee Simple Titleholder's Name (if other than owner)- Address. - City: Mortgage Lender's Name: Address: City: 0 Same as Owner State Zip - © Not Applicable State: zip: Bonding Company ❑Not Applicable Name: Address; City: State: Zip: OFFICE USE ONLY Is the property located in a Special Flood Hazard Area (floodplain) per the current Flood Insurance Rate Map (FIRM) ❑ Yes ❑ No Flood Zone: Reviewed by: Determination: Permit Fee $ Other State Surcharge $ Other Subcontractor Total, Amount Due at Issuance Remarks Flood Review Fee Plan Review Fee $ Routing Fee Other E Violation 0 Yes0 No Reviewed by Date Final Check Date Page 2 of 2