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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: aaoa,_o�53
- r=CETVEO
MUMW-- -- Building Permit Application
Planning and Development Services ucle County, Permitting
Building and Code Regulation Division g
2300 Virginia Avenue,Fort Pierce F134982
Phone:-(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:SPECIALTY PERMIT
PROPOSED IMPROVEMENT,LOCATION:
Address: 2302 RIVER HAMMOCK LANE
Property Tax ID#: 3404-702-0007-000-3 Lot No.7
Site Plan Name: Block No.
Project Name: RIVER HAMMOCK PROJECT-WATER INSTALL.
DETA'ILE'D DESCRIPTION OF WORK: 77�
SET WATER METER TO EXISTING SERVICE AND RUN 1"LINE TO HOUSE AND TIE WITH COPPER ABOVE GROUND
LEAVING JOINTS EXPOSED FOR INSPECTION.
CONSTRUCTIONs IrNFORMATION:
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:
01N'NER/LESSEE a CONTRACTOR`:'
Name NOREEN ANGELONE-ROBERSON Name:CITY OF PORT ST LUCIE UTILITY SYSTEM.
Address:2302 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.(772) 519-1338 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.
SUPAE AMTIL CONSTR`,lJ`CTl0rWLIEN i LAW-[4O.RMATI'OR,
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 thepermit 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 T E JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YQWLENIB R AN ATTORNEY BEFORE RECORDING YOUR NOTIJW OF'COMMENCEMENT."
Signature o Own 6rl Les ee/Contractor as Agent for Owner Signature of Co tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Si-_1 I f1 Q, COUNTY OF StLucle
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this a'1 day of 20,9b by this 04 day of February 20_a by
Brad Macek
Name of person makink statement. Name of person making statement.
Personally Known V1 OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Qffi&1,tL uk"
ignature of Nota Publ' - (Sig ture of Notary Public-St a of Florida)
,?O1 ppV Pvef�L JEANE�TTE7fi0MtsSON
JEAA�ygTJ&I�
Commission No. a. �°= ���A!)Publtc•State of Flori la mission No. ��': Notary Ptjbtic_State of OF Florida
�. Commission
MY Comm.Ex •*GG 037064 +• Commission GG 03
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onded th ough National Not r A sn. :� . omm Exp,es 0 t 14,2020
REVIEWS FRONT ZO N LA VEGET t.t�n N tigga{ �/
COUNTER REVIEW REVIEW REVIEW REVIEW RE I i
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19