HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/28/2016 Permit Number:
s
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: 32 Lake Vista Trail 107 Port St_ Lucie
Legal Description: Vista St. Lucie Building 32 Unit 107
Property Tax ID #: 3422-500-0441-000-3
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:
Additional worK to je�e orme un er t is permit — c
❑_ HVAC LJ Gas Tank E]Gas Piping
Electric Q Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 850.00
Left Side:
a
Lot No.
Block No.
ElShutters Q Windows/Doors
DGenerator Roof Roof pitch
S. of First Floor:
UtilitiestSewer 0Septic Building Height:
OWNER/LESSEE:
Name Virginia Levy JR)
Address: 32 Lake Vista Trail 107
City: Port St. Lucie State: FL
Zip Code: 34952 Fax:
Phnna Nn_ 772 340-7580
E -Mail:
Fill in fee simple Title holder on next page (if different
from the Owner listed above)
CONTRACTOR:
m,m,- GaryW. Zanello
Company: Port St_ Lucie Plumbing
AridrPSs: 6907 Heritage Dr
City: Port St Lucie State: FL
Zip Code: 34952 Fax: 772 489-9126
Phone No. 772 468-6524
F -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 LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Prone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
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
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 pians, 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 your Notice of Commencement.
.11ji, 1XIIZv"'Ail
Signa r f Own essee/ ontractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF sc Lucie
The for in instru end_ as acknowledged before me
this ,= of f 20 &by
Gary W. Zanello a
(Name of person acknowledging)
(Signature of Notary Public -
Personally Known x
Type of Identification
Commission No. FF901
Revised 07/15/2014
s
Signatur o ontra License Holder
LI -11
STATE OF FLORIDA
COUNTY OF St. Lucie
The forgoing Ins*nimc3acknowledged before me
this ,Z�y of �7�a�� , 20 /6 by
Gary W. Zanelio
(Name of person acknowledging)
of Florida) (Signature of Notary Public- State of Fl Ida )
uced lde%*�Mln Personally Known x OR Produced identification
COMMISSION #FFNIO99 Type of Identification Prod*&M •, Danielle Bi fn
URNM Nam 25. W!f' COMMISSION #FF9 IM
w fWoNNOTARY.Cofd FF901099
Commission No. August 25,2M9
` WWW.AAFtONNoTARY.com
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