HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED C100y— Ole oq6
Date: Permit Number:
A
2020
11'Ay 2 IS
Building Permit Applicition
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Planning and Development Services ' `-U ing DEP,-'
Building and Code Regulation Division li-in I-nu.-.-Y
2300 Virginia Avenue,Fort Pierce FL 34982 L-------
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:SPECIALTY PERMIT
PROPOSED IMPROVEMENT LOCATIQN:,-.
Address: 2405 RIVER HAMMOCK LN
Property Tax ID#: 3404-313-0011-020-6 Lot No.2
Site Plan Name: Block No.
Project Name: RIVER HAMMOCK PROJECT-WATER INSTALL
SET WATER METER TO EXISTING SERVICE AND RUN 1 LINE TO HOUSE AND TIE IN 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:
'OWNER/LESSEE: CONTRACTOR.
Name DEBRA FARMER Name:CITY OF PORT ST LUCIE UTILITY SYSTEM
Address:2405 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) 529-1930 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.
SUgPaPLEMENTA'L CO;NSTRUCTfON LIENLAW INFORM4TI0,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 THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YeOW111 OR AN ATTORNEY BEFORE RECORDING YOUR N&ICE OMMMENCEMENT.7
Signature of t!91
as Agent for Owner Signature of Contract r/Li nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S-�- I-u cry COUNTY OF S-)-- Luc i'Q-
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of May ,20,?-Q by this_qday of 1M(ky ,20,'�Q by
Name of person makin statement. Name of person making statement.
Personally Known V OR Produced Identification Personally Known y_OR Produced Identification
Type of Identification Type of Identification
Produced Produced
'�:>OJA Q
(Sign ure of Nota P li -State f Florida) (Sign re of Nota -
.��"""'• JEA TT THOMP50N .•`a�''° JEANETTE' HOMPSO,N
Commission No. ,,o�' `'a;'•: E �:P `''
�7€€QQ I) Commission No. ;'r°. .%; Notary Put(I �te of Florida
Notary P�ti� State of Florida Commission.;µGG 037064
•: ;• Commission Ar GG 037064 M Comm.
vnin•y�6OF Fl F�j jai ``
''•� " Bonded through Naio Bonded through Nat onal Notary Assn.
REVIEWS F Flit fio PLANS VEGET E
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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COMPLETED
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