HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: I �5 Permit Number: 1 005 3
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--�} Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginio Avenue,Fort Pierce FC 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing — w qtc
PROPOSED IMPROVEMENT LOCATION:
Address: 33 Lake Vista Trail 101 Port St.Lucie, 171 34952
Legal Description: Vista St. Lucie Bldg.33 Unit 101
Property Tax ID#: 3422-500-0449-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Lett Side:
DETAILED DESCRIPTION OF WORK:
Supply and install 30 gallon electric water heater(like to like)
CONSTRUCTION INFORMATION:
ACIOnional work to be erformed under this permit—check all appy:
HVAC Gas Tank 7Gas Piping fn_Shutters ❑Windows/Doors
Electric 0 Plumbing Sprinklers n Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 800.00 Utilities:cnSewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Minh Williford Name: Gary W.Zanello
Address:33 Lake vista Trail 101 Company: Port St. Lucie Plumbing,Inc.
City: Port st.Lucie State:Fl Address: 6907 heritage Dr.
Zip Code: 34952 Fax: City: Port St.Lucie State:FI
Phone No.772 342-1738 ; Zip Code: 34952 Fax: 772 489-9126
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 construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION 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 HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I 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 your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencin work or recQ;ding Vour Notice of Commencement. 6'
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_Sign a of ner/Le s e/Agent Igna re Co or/Lice a Holder
STATE OF FLORIDA ST OF FLORIDA
COUNTY OF St tai. COUNTY OF st rude
The f,o�r p�ing instru ent s acknowledged before me The forgoing instrument was acknowledged before me
this t or day of ��D 20 [5-by this 1st day of September 20 _by
(%4 r t/ k(, 76 n e f�[� Gary W.Zanello
(Name of person acknowledging) (Name of person acknowledging)
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(Signature of Notary Public- to of Florida) (Signature of Notary Public-Stat. f Florida)
Personally Known x OR Produced Identification Personally Known X OR rii}�ed Identifi tiq�q
Type of Identification Produced Type of Identification Produ l`L Uaf! H
COMMISSM #MIM
Commission No. FF901099 �7�F eal)C MIMIDN 01MI Commission No, FFBD1099 (S RES X125 2Q13
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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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