HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0?_N346 Permit Dumber:
RECER":D FEB 16 2016
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 Residential X
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 16 Lake Vista Trail 205
Legal Description: Vista St.Lucie Building 16 Unit 205
Property Tax ID#: 3422-500-0222-000-2 Lot No.
Site Plan Name: Block No.
Project Name.
Setbacks Front Back:_Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace 30 gallon electric water heater (Like to Like)
CONSTRUCTION INFORMATION:
Additional war Ktol3e nerformed under this—perm—it—c eck all Mat apply:
OHVAC Gas Tank r❑]Gas Piping 0Shutters Windows/Doors
Electric Plumbing OSprinklers Elenerator U Roof
Total Sq. Ft of Construction: SQ.Ft.of First Floor.
Cost of Construction:$ 850-00 Utilities:0 Sewer r]Septic Building Height;
OWN ERAESSEE: CONTRACTOR:
Name Boulay(TR) Name: Gary W.Zanello
Address:16 Lake Vista Trail 205 Company: Port St. Lucie Plumbing
City: Port St.Lucie State:F1 Addiess- 6907 Heritage Dr.
Zip Code: 341952 Fax: City. Port St.Lucie State:Fl
Phone N(3.772 878-1843 Zip Code: 34952 Fax: 772 489-9126
E-Mail: Phone No. 772468-6524
Fill in fee simple Title Holder on next page(if different E-Mail: portstiucieplumbing@gmaii.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:
DESIGNERIENGINEER: 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 tender or an attorney before
commencin work or recording your Notice of Commencement.
Signature of 6wne J Lessee) nt Signature of Cdntract111 License
/ /P111der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFsi.Lwe COUNTYOFst.Lucta
The f The forgoing instrument was acknowledged before me
this �qoomg instrugnept was acknowledged before me
—day of4f5b. 20 LG_by this 's day of February 20 16 by
ZgAtt/0 Gary W.Zanello
(Name of person acknowledging) (Name of person acknowledging)
Al_/,-It�, &4&— I xia�& &&_
(Signature of Notary Public- tate of Florida) (Signature of Notary Public-Sta—/e of—Florida
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produc tulystType of Identification Produced
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99 10 FFS01099
Commission No. FF13010 (Se ISSION OFF001M Commission #Rolm
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Revised 0711512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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