HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUSI BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3c)- I Permit Number: 15011 - 0
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Building Permit Application
Planning and Devefqjament Se vices
Building and Code Regulation Division
2300 Virginia Avenue,Fort Ph rce FL 34982
Phone:(772)462-1553 Fa(:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing
-PROPOSED IMPROVE ENT LOCATION:
Address: 123 Aldea Ct.
Legal Description: River Par'.Unit 3 Block 28 Lot 12
Property Tax ID#: .9 z5/- ,5 LO a 6/ Lot No.12
Site Plan Name: Block No. 28
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIC N OF WORK:
Replace 40 gallon watE r (Like to Like)
CONSTRUCTION INFORMATION:
Additional work to be Dertrme un erthis permit-check all that apply:
OHVAC Gas Tank FGas Piping F Shutters F]Windows/Doors
Electric 0 Pl mbing MSprinklers, FIGenerator 0 Roof
Total Sq.Ft of Construction Sq.Ft.of First Floor*
Cost of Construction.*S 700 00 Utilities:Ian!SewerSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Amber Vinz Name: Gary W.Zanello
Address:711 SE Celtic Ave Company:-Port st.Lucie Plumbing,Inc.
City: Port St.Lucie State:R Address: 6907 Heritage Dr.
-tip Code. 34983 Fax: City: Port Stt.Lucie State:F1
Phone No.772 812-6033 Zip Code: 34952 Fax:
E-Mail: Phone No. 772 468-6524
Fill in fee simple Title Holt er on next page(if different E-Mail: portstuc7ieplumbing@gmaii.com
from the Owner listed ab i me) State or County License: CFC058025
If value of construction is 0 or male,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CON s rRUCTION 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 HOLDS I I,: r Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone,
I certify that no work or install ition has commenced prior to the Issuance of a permit.
St.Lucie County makes no rep[esentation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any ap)Iicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with 1.our Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the grantift,;of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approv!d plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit i pplications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimmir�.,pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Y mr failure to Record a Notice of Commencement may result In your paying twice for
improvements
m rovemets t'o your pr)perty.A Notice of Commencement must be recorded and posted an the jobsite
before the Wirstinspecticii . If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
S
SignaturjofXcntra,�Wliceiise older
Si re cif�rmn`erflesseej gent
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SL Lucie COUNTY OF-LL-
The
F-LL-
The forgoing instrurqent�%yas icknowledged before me The forgoing instrument was acknowledged before me
this$O day of. Awl I ... go L5bv this 30", day of A pri 20 1-5 by
Cqmy W.Zanevo Gety W.Zanello
(Name of person acknowledgi ig (Name of person acknowledging)
(Signature of Notary Public-5 mte/of Florida) (Signature of Notary Public-Stat of Florida)
Personally Known x 01 Produced Identification Personally Known x OR Produced Identification
Type of Identification -3j—
Produci Type of Identification Produced
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Commission No. AU 3.2 5.2 015 Commission No. CFC0561025
WMPARONNOTARYCOM P;RES:AUG.25,2015
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Revised 0711512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETA-TION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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