HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _ • �'� •2 Permit Number:
Y
RECEIVEDIN,
0
- I M- 01 MAR 10 2020
Building Permit Applicatio
Planning and Development Services
ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:SPECIALTY PERMIT
Address: 2306 RIVER HAMMOCK LANE
Property Tax ID#: 3404-702-0005-000-9 Lot No.5
Site Plan Name: Block No.
Project Name: RIVER HAMMOCK PROJECT-WATER INSTALL
D"LED�DESCRIPTION OF WORK j N, n
SET WATER METER TO EXISTING SERVICE AND RUN 1" LINE TO HOUSE AND TIE IN WITH COPPER ABOVE
GROUND LEAVING JOINTS EXPOSED FOR INSPECTION.
m - �
CONSTRUCTION INFORMATION: ���4 t` _
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 T
CONTRACTOR " r
Name JAMIE TURNER Name:CITY OF PORT ST LUCIE UTILITY SYSTEM.
Address:2306 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)332-6380 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.
SUPPLEiVIEN1-AL CONSTRUCTION LIEN LAW INFORMATION r `{ s
. .
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YO ND TO OBTAIN FINANCING, CONSULT
WITH YO LEND R AN ATTORNEY BEFORE RECORDING YO NOTIC OMMENCEMENT."
Signature of-Ow tt/L see/Contractor as Agent for Owner Signature of Con actor icense Holder
'4r��2
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF 5 _Ll.t LLt_,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Q`l day of 1= r it 20 Eby this
�D-7 day of <FY- VILLa r 2000 by
Name of person making!statement. Name of person makink statement.
Personally Known 1/ OR Produced Identification Personally Known t/ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(�& 4M-Cmv 11
nature of Notary Pu`li a gnature of Notary Pu - AMi�f
YP'•.,, EANETTE THOMPSON ��au���,,
°tom `8�,, JEANETTE THOMPSON
;:. ,c yotar Public-State of Florida Notar� � State of Florida
Commission No. _•' ;•5 ( mission#GG 037064 mmission No. Commission#GG 037064
�N9 ;� My Comm.Expires Oct 14,20 0
4h},OFF�O�, .,��F `°a,, My Comm.Expires Oct 14 2020
one throw h National Notary Assn.
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COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/1/19