HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: August 17, 2021 Permit Number:
(�Ir
R
D 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: 33 Lake Vista Trail 101 Port St Lucie, FL 34952
Property Tax ID #: 3422-500-0449-000-9 Lot No.
Site Plan Name: Block No.
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:
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 hoof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1,800.00 Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Mitchell Williford
Name: Gary W Zanello
Address:33 Lake Vista Trail 101
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.772 342-1738
Zip Code: 34952 Fax:
E-Mail:
Phone No772 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 71;Of1 nr mnra a RFrnanrn rim. a -f r.............
. . ..4 : __ __s
..__ '--____ -- ��..........�.....�..�... .�.�.... Otis.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
! SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 1
DESIGNER/ENGINEER: _ Not Applicable
Name:_
Address:
City:
Zip:
Phone
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 commencing work or recording our Notice of Commencement.
Signature ner essee ontractor as Agent for Owner
STATE OF FLORIDA
COUNTY 0FStLum
Sworn to (or affirmed) and subscribed before me of
Ph sical Prese ce or Online Notarization
this day of VQ T 2020 by
Gary W zanello
Name of person making statement.
Personally Known xx OR Produced Identification
Type of Identification
Produced
lya't cJ Danielle
(Signature of Notary Publi - , f )comm.1653111
Commission No. GG360656 F, -= 021
ftAM
Signa of C ractor/License Holder
STATE OF FLORIDA
COUNTY 0FstLu ie
Sworn to (or affirmed) and subscribed before me of
Physical Prese ce or Online Notarization
this J day of 9!?US 2020 by
Gary w zanello
Name of person making statement.
Personally Known xx OR Produced Identification
Type of Identification
Produced
of Notary
"1- :�II 21, 2M
fission Na. ccssa"I
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