HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: September 21, 2016 Permit Number:
a s ,J _
ago
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 3498.2
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: 6 Lake Vista Trait 106 Port St. Lucie
Legal Description: Vista St. Lucie Bldg. 6 Unit 105
Property Tax ID #: 3422-500-0076-000-3
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Replace 30 gallon electric water heater and 3/4" ball valve (like to like)
Lot No.—
Block No.
CONSTRUCTION INFORMATION:
A00itional work toe e orme under this permit •- c ec a appy:
11HVAC 11 Gas Tank ❑Gas Piping _Shutters O Windows/boors
aElectric 121 Plumbing Sprinklers E]Generator E] Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: S 875.00
SFt. of First Floor: _
Utilitiesl]Sewer 0 Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Bertram DeSchene
Name: Gary W. Zaneilo
Address: 6 Lake Vista Trail 106
Company: Port St. Lucie Plumbing
City: Port St. Lucie State: Fl
Zip Code: 34952 Fax:
Phone No. 772 200-1361
Address: 6907 Heritage Dr.
City: Port St. Lucie Plumbing 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 above)
E -Mail: portstiucieplumbing@gmail.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 Count 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 roust be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
I.UII111tCI11,11EK WUIKUI 10E..VIU111V'VUU1 1VUL1UV_ VI l.UE111fIC11l.CIlECl16.
Signat of Ow Lessee/Contractor as Agent for Owner Signatur f Contra r/License Holder
STATE OF FLORIDA
COUNTY OF st iL
The forgoing instruraent was acknowledged before me
this ,V5 ay of e 20 l4by
Gary W. Zanello 1
(Name of person acknowledging)
STATE OF FLORIDA
COUNTYOF- ..1E
The forgoing instrument was acknowledged before me
this 21st day of_SLph-n er 20 by
Gary W. Zanello
(Name of person acknowledging)
(Signature of Notary Public- S e of Florida J (Signature of Notary Public- Sta f Florida J
Personally Known X OR Produced Identification
Type of identification Produc �✓ Danielle glylin
MISSION OFF901099
Commission No. FF901099 ��C ��a►� (Se amRES:August 25.2019
www.AAR0tiNOTARY.com
Revised 07/15/2014
Personally Known X OR Produced Identification
Type of Identification Prod ' E " �. Danielle ki lin
COMMISSION #Fi%lM
Commission No. FFsoloss= ?12 Aupust25,2019
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