HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: November 29, 2016 Permit Number:
Cca►U NT Y ....,,,,�
F L Q a n o n
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
23010 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: 16 Lake Vista Trail #206 Pori St. Lucie
Legal Description: Vista St Lucie Building 16 Unit 206
Property Tax lD #: 3422-500-0223-000-9
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side:
Left Side:
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I
Replace 30 gallon electric water heater (like to like)
CONSTRUCTION INFORMATION:
Additional work toe bertormed under tis permit —check a appy:
HVAC1:1 Gas Tank ❑Gas Piping Shutters Q Windows/Doors
11 Electric R Plumbing Sprinklers OGenerator 0 Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction. $ 900.00
S Ft. of First Floor: _
Utilities: Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Pamela Lachance
Name: Gary W. Zanello
Address: 16 Lake Vista Trail 206
Company: Port St. Lucie Plumbing
City: Port St. Lucie State: FL
Zip Code: 34952 Fax:
F f
Phone No_
Address: 6907 Heritage Dr_
City: Fort 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 i if different
from the Owner listed above)
E -Mail: portstlucieplumbing@gmail.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
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a perm ft.
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 Cortes 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 vour Notice of Commencement.
A
& Jljy—1 All
1#7 - I c %, I oz -11F I'-
s
ig e o ner Lessee/Contractor as Agent for Owner Sig7TE
o attar 'cense Holder
STATE OF FLORIDA SF FLORIDA
COUNTY OF Sc Lucie COUNTY OF sL
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this c day of /l(d z4 Eby this oday of _%Gld v 20 by
Gary W. Zanella Gary W. Zanello
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public- S e of Florida) (Signature of Notary Public- State of FI lda )
Personally Known x OR Produced Identification Personally 'Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF9o1a99 (Seal) FF9o1 �'...�
Danielle �i91in
Commission No. CORA #FF901099
Danl$IN Biglin EXPIRES: AuaWt 25.2019
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+ EXPIRES: MOM 25.2019
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