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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 111
Date: Permit Nurrbar
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......... RECEIVED
COUNTY
• NOV -4 2019
Building Permit Appl cation
Planning and Development Services Permitting Department
Building and Code Regulation Division St. LUCie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE: G ot► 1 �� J
-PROPOSED IMPROVEMENT LOCATION
Address 2401 N 43rd St Fort Pierce, FL 34946
Property Tax ID#: 1431-801-0182-000-5 Lot No. 9AND S 11 OF LOT TO
Site Plan Name: 2401 N 43rd St Fort Pierce, FL 34946 Block No. 15
Project Name: Jasmine A Bernard ;Joseph M Bernard
DETAILED DESCRIPTION OF WORK:
._i
ROOF
CONSTRUCTION INFORMATION: F
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator X Roof Pitch
Total Sq. Ft of Construction: j ft Fk1- Sq. Ft. of First Floor:
Cost of Construction:$ 23,950 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Jasmine A Bernard ;Joseph M Bernard Name: BURKE HAMMOND
Address:2401 N 43rd St Company:FH 1A, LLC
City: Fort Pierce State: FL Address: 3044 SW 42 ST
Zip Code: 34946 Fax: City: HOLLYWOOD State:FL
Phone No. ';1 Z Z-cZS 6,r Zip Code: 33312 Fax: 407-4728380
E-Mail: Phone No 954-7924415
Fill in fee simple Title Holder on next page(if different E-Mail orlandopermits@fhaproducts.com
from the Owner listed above) State or County L'icense C-U-k3.3v"�b0
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 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 TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Sign 9.ke of Owner/Lessee ontractor as Agent for Owner Signature of Contractor/License Ho er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF f>S I_'_'6X_ COUNTY OF 5�• Lu 2
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this-c\-day of 20keL by this day of C5(A-- 20�c'by
G�r -rte_ 79:�Vna.vA
Name of person making statement. Name of person making statement.
Perso ly Known OR Produces�islentification Personally Known OR Produ ���'Vation
Type Identification o ��p Type of Id tificatio 63 Q
Pro ced .C1 Ali �kr& ��� � Produce
ur otary Public-State o ure of - ateq- id�.0
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Commission No.�Qosue �� eal) Commission No. (Seal)
REVIEWS 4be ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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