HomeMy WebLinkAboutBuilding Permit Applicationft sk. -4--4aina a
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED .. j
Date: April_30, 2021...Permit ��
Number' 1
Building Permit.Application
Planning and Development Services
Building and Code Regulation Division s Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553. Fax: (772) 462-1578
PERMIT APPLICATION FOR: Ronald M Bernhard -
Address: 204 Nettles Blvd Jensen: Beach, Florida 34957-3312
Property Tax ID #: 4502 501 039.0 000 1 Lot No:204
Site Plan Name: Bernhard Block No:
Project Name: BERNHARD
New 4000 PSI concrete slabs with fiber mesh. 820 sq ft of new; concrete_ home slab 4" in thickness with (1) # 5 rebar 8"
x 8" thickened. edge, 450 sq ft of parking area and 380 sq ft of "deck" area:. fora. total of.1650 +/- sq.ft.. All areas shall be ajoining.
New Electrical Meter Second Electrical Meter ..
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Additional work to be performed under this permit- check all that.apply:
_Mechanical _ Gas Tank Gas Piping Shutters _ Windows/Doors Pond
_ _ _
_Electric Plumbing _Sprinklers _Generator Roof Pitch
Total Sq..Ft.of Construction: 1650 Sq. Ft. of First Floor:
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Cost-ori`al� Utilities: ._ Sewer. _ Septic. Building. Height:.
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'I,L,I nefee simple Title Holder if different E°
on next page ( Mai�j�V�j
from the .Owner listed above).tatCounty License26 _
If.value of construction. is 2500 or more, a RECORDED Notice of Commencement is.required. :
If value of.HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorneybefore commencingwork or recordingour Notice of Commencement.
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248160
�S`gna ui'e'yof�Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF SalntLucle
COUNTY QFSaintLucie
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
x Physical Presence or Online Notarization
t ' o day of nPri 2021 2 0 by
his so of nPdi zort 2020 y
Name of person making statement. _
Name of person making statement.
Personally Known OR Produced Identification x
Personal wn X OR Produced Identification
Type of Id ntificetion
Type o Identific tion
Produce FI ' aDn .rsLicenses
Prl. od ec��"
(Signature of Notary Public- State of Florida
ature of Notary Public -
;;�t•••••�:a:. AUTUMN N. BURNS
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Commission No. ••�S��OMMISSION#GG
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