HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/25/2016
CC3iJ [V T Y
F L O R I 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 101
Legal Description: Vista St. Lucie Building 20 Unit 101
Property Tax ID #: 3422-500-0267-000-9
Site Plan Name:
Project Name: _
Setbacks Front
Back: Right Side: Left Side:
IDETAILED DESCRIPTION OF WORK:
Replace 30 gallon electric water heater (like to like)
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work to be nertormed under t—chockispermit a appy:
HVAC Gas Tank ❑Gas Piping _ Shutters I l Windows/Doors
11 Electric Plumbing Sprinklers Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 875.00
Sq. Ft. of First Floor:
Utilities: Sewer F1Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Bradley Stoldt
Name: Gary W. Zanello
Address: 2720 NW 74th Ave.
Company: Port St. Lucie Plumbing
City: Margate State: FL
Zip Code: 33063 Fax:
Phone No. 952 769-7572
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 above)
E -Mail: portstlucieplumbing@gmaii.com
State or County License: CFC058025
It 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-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
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ign r f Own essee/ ontractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF st Lillie
The forgoing instr m n was acknowledged before me
this v2_15 dayof C'/J 20 & by
Gary W. Zanello i
(Name of person acknowledging)
11 I, CI I% -CI I ICI Il.
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(Signature of Notary Public- Sta f Florida
Personally Known x O , duced Idenfica�''lop.
Type of Identification Prod��°j'; I73[IICIl2 tI�II�
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Commission No. FF901099 (
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ONNOTARY.COM
Revised 07/15/2014
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Signat e Contr r Li se Holder
STATE OF FLORIDA
COUNTY OF st. Lucie
The forgoing instrument was acknowledged before me
this 45 day of a n_ 20 by
Gary W. Zanello
(Name of person acknowledging)
(Sign41W'U�� &�Z_lZz7lc
tore of Notary Public- Stat Florida )
Personally Known x ` diced Iden
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Type of Identification Pro b ISStON__!FF90IO99
=�c Z EXPIRES: August 25, 2029
Commission No. Frgcyn99 °;`'`;,� ;;��` j{ONMOTAIiY.COM
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