HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t� q
Date: a-0 Permit Number:
• . RECEIVED
- - Building Permit Applicati n
FEB 2 8 240
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:SPECIALTY PERMIT
PROROSED IMPROVEMENT LOCATION:
Address: 2101 RIVER HAMMOCK LANE
Property Tax.ID#: 3404-313-0011-220-8 Lot No. 12&13
Site Plan Name: Block No.
Project Name: RIVER HAMMOCK PROJECT-WATER INSTALL.
DETAILED DESCRIPTION OF.WORK:
SET WATER METER TO EXISTING SERVICE AND RUN 1"LINE TO HOUSE AND TIE WITH COPPER ABOVE GROUND
LEAVING JOINTS EXPOSED FOR INSPECTION.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
_Mechanical —Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ $544.00 Utilities: _Sewer _Septic Building Height:
,w
OWNER/LESSEE:' 'CONTRACTOR:
Name SUSAN BACHER Name:CITY OF PORT ST LUCIE UTILITY SYSTEM.
Address:2101 RIVER HAMMOCK LANE Company:
City: FORT PIERCE, FLORIDA State:_ Address:900 SE OGDEN LANE
Zip Code: 34981 Fax: City: PORT ST LUCIE State:FL
Phone No.(575)513-2131, (575)513-2187 Zip Code: 34983 Fax:
E-Mail: Phone No(772) 873-6400
Fill in fee simple Title Holder on next page(if different E-Mail UTILITYWATER@CITYOFPSL.COM
from the Owner listed above) State or County License 25597
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.
SUaP71%6L tAL CON R; T®1 IEN LAWr INtF®R %IFATiO;N �
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 B SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YO LE E O AN ATTORNEY BEFORE RECORDING YOUR ICE COMMENCEMENT."
Signatu of Owne Less a/Contractor as Agent for Owner Signature Contrfor/License Holder
_ STATE OF FLORIDA STATE OF FLORID
COUNTY OFCOUNTY OF St Lucie
The forgoing instrum nt was acknowledged before me The forgoing instrument was acknowledged before me
this pa day of Fpbruar 200D by this 04 day of February ,20 go by
IN V,It a s�t t _-',' Brad Macek
Name of person making istatement. Name of person making statement.
Personally Known ✓ OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
ignature of Notary Public-5%%V
ure of Notary Public-St a of Florida)
'a""'.,, JEANETTE TROMPS48 N f Lary Public-State of FIpr ,��QY p'�. JEA �f�jFIOMPSON
Commission No. +� ea p d6� ssion No. <P �e )Commission #GG 03 . �; 'Notary Public-State of Florida
My Comm.Expires Oct 14,2020 : :• Commission. GG 03706
a lona ary ssnRe 0 . -%,� .tea
°�f"���_ MY-Comm.Ex ares Oct 14,2020
REVIEWS FRONT ZONING S P R IS R P S VEGET �911 NaIMANG UVE
COUNTER REVIEW REVIEW REVIEW REVIE nVlt
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