HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: September 16, 2016
F QU NTY
F L O R [ D A
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: 20 Lake Vista Trail 107, Port St. Lucie
Legal Description: Vista St. Lucie Bldg. 20 Unit 107
Property Tax ID #: 3422-500-0273-000-4
Site Plan Name:
Project Name: _
Setbacks Front
Back: Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
&JP6 Ond i s 1J . 3/) allon elec �ric vvar er_ Aeal, r
rlike t lisle,)
CONSTRUCTION INFORMATION:
Additional work to be ertormea under this permit— check all appy:
i=1 HVAC Gas Tank F]Gas Piping Shutters Windows/Doors
FlElectric ❑✓ Plumbing Sprinklers E Generator LJ Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $
SFt. of First Floor:
Utilities1iSewer []Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name George Kosmes
Name: GaryW. Zanello
Address: 80 Valley Rd.
City: Wells State -YE
Zip Code: 04090 Fax:
Phone No. 603 770-7257
E -Mail:
Company: Port St. Lucie Plumbing
Address: 6907 Heritage Dr.
City: Port St. Lucie State: FL
Zip Code: 34952 Fax: 772489-9126
Phone No. 772468-6524
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: portstlucieplumbing@gmail_com
State or County License: CFC058025
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIED 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 thepermit 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
LUIr1I11eFIC111h{ WUI K UI IeLU1U11114- VUUF NULIL U UI l.U1i1I11e11Le1ne11L.
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Sign a wner/Lessee/Contractor as Agent for Owner i Li a of tractor/License Holder
STATE OF FLORIDA
COUNTY OF st Lud.
The forgoing instrument was acknowledged before me
this 16 day of 20 �5_by
Gary W. Zanello —(Name of person acknowledging)
(Signature of Notary Pu c- State of Florida )
C ` _
Personally Known x IdentifiMp giplin
Type of Identification Produ ct! COMMISSIDN FFF901099
tAMNa�U19
Commission No. FF901099 , ; � � (smrAAAONNoTAHY.COM
Revised 07/15/2014
STATE OF FLORIDA
COUNTY OF sL Lucie
The forgoing instrument was acknowledged before me
this 16"' day of September 20 16 by
Gary W. Zanello
(Name of person acknowledging)
.
, 5j-
✓L>11
(Signature of Notary Public- Stat f Florida )
Personally Known x OPP-�-F` !`li Identifica 'or)
Type of Identification Produce* "'
COWSSION FFF901M
Commission No. FF901099 �d,�l��$(Sea PoRES;AI'q'Kt25.2f11s
'sig 11FFLa i�`` 1N.AARONNOTARy.coM
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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DATE
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INITIALS