HomeMy WebLinkAbout2307 River Hammonck Ln Permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _ �_ SL Permit Number:
9-�r-LfLm-
r p
T f s J
Building Permit Application
Planning and Development services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential x
PERMIT APPLICATION FOR:
Q
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #: - y Lot No. —
Site Plan Name: Block No.
Project Name:
! DETAILED DESCRIPTION OF WORK: I
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION: 1
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: Sq. Ft. of First Floor:
Cost of Construction: $ _� Q� Utilities: —Sewer —Septic Building Height:
OWNERAESSE O ;de w
CONTRACTOR:
Names
Address: �� iV
Name: JOSEPH F TULLY
Company:GENESIS PLUMBING SERVICES INC
City: Statel'-7L
Zip Code: Fax:
Phone No. rir"R ®
Address: 1532 SE VILLAGE GREEN DRIVE UNIT B
City: PORT ST LUCIE State: FL
Zip Code: 34952 Fax:
Phone No 772-337-3682
E-Mail: r Mrf-,
Fill in fee Vmple Title Fielder on next page (if different
from the Owner listed above)
E-Mail GENESISPLUMBINGOFFICE@GMAIL.COM
State or County License CFC1429103
it vawe or construction is "ZSUU 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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: Applicable
Name:
_Not
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 attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
gnature of Co'ntra-ctarf Lice ns
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OFs-r
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of by
X P ' al Presence orOnline Notarization
A_
2020
this ay of 202J by
BARBARA J LOPEZ
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced F,
f) -
(Signature of Notary Public- State of Florida)
(Signature of Notary Publi ,_ e o lorida)
Gommission No. (Seal)
o,,ILY.PLei BAREMRA,i.LOP-
Commission No. He099764 _ 'al>LommissioniiHH0
6
N� o� Expires April 24, 202
Bonded TNu &01,k Notary Se
' .
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20