HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MILL, BE COMPLETED FOR APPLICATION TO BE ACCEPTED (�
Date: Permit Number:
O
Building Permit Application
Planning and Development S ervices
Building and Code Regulativ Division
2300 Virginia Avenue, Fort P erce FL 34982
Phone: (772)462-1553 F x:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVE 0ENT LOCATION:
Address: 124 SE Soneto C
Legal Description: River Pa k Unit 7 Block 69 Lot 4
Property Tax ID#: 3419-55 -0083-000-0 Lot No.4
Site Plan Name: Block No. fig
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace 40 gallon elec ric water heater(like for like)
CONSTRUCTION INFORMATION:
Additional work to 13P oprtc rmed under this permit—check a appy:
HVAC G s Tank E]Gas Piping _Shutters ❑Windows/Doors
11 Electric 0 Plumbing []Sprinklers Q Generator F] Roof
Total Sq.Ft of Construction: 5 Ft.of First Floor:
Cost of Construction:$ 700 0 Utilities:Sewer 1:1SepticBuilding Height:
OWNER/LESSEE: CONTRACTOR:
Name Kenneth Herz Name: Gary W.Zanello
Address:P.O.Box 8106 Company: Part st. Lucie Plumbing
City: Pittsburgh State:Pa Address: 6907 Heritage Dr.
Zip Code: 15217 Fax: City: Port st.Lucie State:FI
Phone No.408-3957 Braxtor iFriend Realty Zip Code: 34952 Fax: 772 489-9126
E-Mail: Phone No. 772 468-6524
Fill in fee simple Title Hold(r on next page(if different E-Mail: portstlucieplumbing@gmail.com
from the Owner listed aba e) State or County License: CFC058025
If value of construction is$25 0 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CON 3TRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SAMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone Zip: Phone:
I certify that no work or instal ation has commenced prior tothe 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 a licable Horne Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with our Home Owners Association and review your deed for any restrictions which may apply.
inconsideration of the grantin of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the appro d plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit pplications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimmi pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Y Jur failure to Record a Notice of Commencement may result in your paying twice for
improvements to your pr perty.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspectio . If you intend to obtain financing,consult with lender or an attorney before
commencing work or rec rdingyour Notice of Commencement.
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_Signa a of O ner/Lessee gent Signature#r Contract /License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF sl.LL-ja COUNTY OF si.L-e
The f oin instrunJe t was cknowled ed before me The forgoing instrument was acknowledged before me
this�hday of /Ila 20/O by this m day of Mme' 20 _by
G&r � . �e llo Garyw.Zanello
(Name of person acknowledgi g) (Name of person acknowledging)
444�� A
(Signature of Notary Publiv,ate of Florida) (Signature of Notary Publi tate of Florida)
Personally Known x OR Produced Identification Personally Known x OR Producgd Identification
con, ��<<�YP���• 0arife!le I In
Type of Identification Produce .�`.ar o;L•.. Danielle BigliR Type of Identification Produced ;��..� o g
z' �'CCMMIS 101€EE 107315 =_.� i0',1t'! �+� ?=107315
Commission No. EE107316 °a. .!f5MRES:AJG.25,2015 Commission No. EE107315 % ,,,.•off : .=.�G.2�,2Q15
WW,4.AARONNOTARYeom �•igi ii:�• Y5^r�1'r.r,.=KGKTrOIhflYco:o
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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