HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: March 15, 2016 Permit Number:
•
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: 4 Lake Vista Trail 205 Port St. Lucie
Legal Description: Vista St. Lucie Building 4 Unit 205
Property Tax ID #: 3422-500-0054-00-3
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Replace 30 gallon electric water heater (like to like)
Lot No._
Block No.
Aaaamonal worK to oe errormea unaer tors permit— cneCK all apply: E
1 ] HVAC _ Gas Tank F]Gas Piping _ Shutters a windows/Doors L
11 Electric WIPlumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 5 FtFtj of First Floor:
Cost of Construction: S 850.00 Utilities: LJ Sewer OSeptic Building Height.
OWNER/LESSEE:
CONTRACTOR:
Name David Larsen
Name: Gary W. Zanello
Address:4 Lake Vista Trail 205
Company: Port St. Lucie Plumbing
City: Port St. Lucie State: F1
Zip Code: 34952 Fax:
Phone No. 772 249-7509
Address: 6907 Heritage Dr.
City: Port St. Lucie State: FL
Zip Code: 34952 Fax: 772 489-9126
Phone No, 772 468-6524
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed alcove)
E -Mail- portstiucieplumbing@gmaii.com
State or County License: CFC058025
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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-residentiai 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
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Signatu of ner/ Lessee/Agent Signature of Contr ctor/Lice Holder
STATE OF FLORIDA
COUNTY OF st Lucie
STATE OF FLORIDA
COUNTY OF sL Luae
The forgoing instrument as acknowledged before me The forgoing instrument was acknowledged before me
this /6' day of n r6, 20 1�by this 151h day of March 20 /6fby
Gary W. Zaneilo i Gary W. Zanello
(Name of person acknowledging) (Name of person acknowledging)
4
(Signature of Notary Public- Stat"f Florida) (Signature of Notary Public- State of FI da )
Personally Known x OR Produced Identification
Type of Identification Produced°�� 1 o DaWletp
Commission No. FF901099 r � OOMMISSIC+N #FF90i
eal) EXPIRES: Augum 25.2
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Revised 07/15/2014
Personally Known X OR Produced Identification
Type of Identification Produgg&V" tr._
Commission No. FF901099 * ani (=� 2�
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