HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1011812016 Permit Number:
;i -
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: 19 Lake Vista Trail 107 Port St Lucie
Legal Description: Vista St. Lucie Building 19 Unit 107
Property Tax ID #: 3422-500-0259-000-0
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side
DETAILED DESCRIPTION OF WORK:
Replace 30 gallon electric water heater (Like to like)
CONSTRUCTION INFORMATION:
itiona wor to a pe orme un ert is permit -c
❑HVAC "Gas Tank "Gas Piping
"Electric 17 Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 850.00
Left Side:
all apply:
_ Shutters
Generator
S Ft. of First Floor: _
Utilities Sewer "Septic
OWNER/LESSEE:
Name Chris McCoy
Address: 19 Lake Vista Trail 107
City: Port St. Lucie State: FL
Zip Code: 34952 Fax:
Phone No. 718 619-5886
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
nlamp. GaryW. Zanello
Lot No.
Block No.
"] Windows/Doors
"Roof = Roof pitch
Building Height:
Company: Port St. Lucie Plumbing
o,�,�rp��• 6907 Heritage Dr.
City: Port St. Lucie State: FL
Zi Code: 34952 Fax: 772 489-9126
V, —
Phone No. 772 468-6524
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:
DESIGNERANGINEER: _ Not Applica
Name: _
Address:
City:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
r'ity•
zip: Phone: _
State:
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City.
Zip: Phone:
Not Applicable
State:
BONDING COMPANY: Not Applicabie
Name: _
Address:
City:_
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
structure. Please conflict consult with pyour Hlome Owners Association Owners Association and review deed or any restrictions which maor
applyhibit such
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
commencing work or recording our Notice of Commencement_
Sign re caner/Lessee/Contractor as Agent for Owner S9 a re o tractor/License Holder
STATE OF FLORIDA
COUNTY OF St. Lucie
The for ping intru n s acknowledged,}?efore me
this 1st day of _ C7�r 20 acknowledged
Gary W. Zanello -1-
(Name
(Name of person acknowledging)
(Signature of Notary Publi tate of Florida )
�,,,� Danielle Riglin
Personally Known x "'..o,d Id -fl �n�94--
Type of Identification Proce
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FF801099
Commission No. �',r ,� (Seal)
Revised 07/15/2014
REVIEWS FRONTI ZONING
COUNTER 4 REVIEW
DATE
COMPLETE
INITIALS
STATE OVFIIFLORIDA
COUNTY OF St. Lucie
The forgoing instrument was acknowledged before me
this 18th day of October 20 by
Gary W. Zanello
(Name of person acknowledging)
(Signature of Notary Public- S e of Florida )
Personally Known x �i'" �] Identifi
Type of Identification ProdLQ- :: = CoAf#IiSStoN OR01099
FF901099 �'h�/F �{ � �RONNOTAFmcoM
Commission No. ��,....,,,,� ��AIl
RO
REVIEWOR I REV EW I PNSV EVIEWON S EV EWLE MRS EWVE