HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED pp��
Date: Permit Number:
- - Building Permit Application
Planning and Development Services MAR 1 0 ?11120
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
PROPOSED IMPROVEMENT'LOCATION '_ � Hk 1 �, `' 3� ,�
Address: 2203 RIVER HAMMOCK LANE
Property Tax ID#: 3404-313-0011-200-2 Lot No.11
Site Plan Name: Block No.
Project Name: RIVER HAMMOCK PROJECT-WATER INSTALL
DETAILED DESCRIPTfON OF WORK
__ _fr_
SET WATER METER TO EXISTING SERVICE AND RUN 1" LINE TO HOUSE AND TIE IN WITH COPPER ABOVE
GROUND LEAVING JOINTS EXPOSED FOR INSPECTION.
CQNSTRUCTID_N INFORMATION. � s -� � - s _ :k � �
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:
OWNER/LESSEE r CONTRACTOR
Name LINDA ANN LAUREIGH-POOR Name:CITY OF PORT ST LUCIE UTILITY SYSTEM.
Address:2203 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)370-0923 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.
SUPPLEMENTAL CONSTRUCTION If LAW INFORMATION 5
x n
d F
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:
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 OB SITE BEFORE THE FIRST INSPECTION. IF YOUR D TO OBTAIN FINANCING, CONSULT
WITH YO 6'LEN R AN ATTORNEY BEFORE RECORDING YOUR NOTI F MMENCEMENT."
Signature' wne Lesse /Contractor as Agent for Owner Signat of Co ractor/ icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �-�-, ) ��-f >Z. COUNTY OF S-h_ 11kLt i
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this.s�j day/off f F 6 f�Cf.�IY 20 c)D by this c}1 day of F7y`U4Lr 2030 by
Cl.yl�RA �4 I,l_l L Q 1n i P d
Name of person makink statement. Name of person making statement.
Personally Known `� OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
G&Wki- . 'q�t'
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ignature of Notary P - JEA ETTE THOMPSON gnature of Notary P blic-
" �"" ` "' JEANETTE THOMFSON
tp{lY PV'q µVP 9
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Notalk, lic-State of Florida ?r°.P •`�? Mir ublic-State of Flori a
Commission No. ° Commission#GG 037064 Commission No. ° ;•= Com fission #GG 03706
My Comm.Expires Oct 14,2020 ';��,E oP�;V My Comm.Expires Oct 14,2 2
NotaryOunded 1111m 11 Idnonal M. ������ one hrough National NotaryA sn
REVIEWS FRONT ZONING SUPERVISO'R PLANS VEGETATION 'SEA TURTLE' A
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19