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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 37
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91T.WSUR
Building pp Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial _X Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
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PERMIT APPLICATION FOR:
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Address: 5990 Emerson Ave Ft. Pierce FL 34951
,Property Tax ID#: Lot No.
Site Plan Name: Lakewood Park Block No.
Project Name:' Lakewood Park Regional Park
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Construct 4 pickleball'courts EWG 6� in is
No mechanical electrical or plumbins
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New Electrical Meter Second Electrical Meter (Affidavit required)
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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: Sq. Ft.of First Floor:
Cost of Construction:$ 99,990 A25000.0 utilities: —Sewer _Septic Building Height:
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Name I (f 1 Name: Zach Stevenson
Address:�I 1VYn ! 1& Company: Nidy Sports Construction
City:T44- gjce- State: [ Address: 751 General Hutchison PkwK
Zip Code: .3`7; Fax: City: Longwood State: FL f
Phone No. {`.-�p-�9 y E- Zip Code: 32750 Fax:
Mail: �rarP S+ JAjo C'�,r%l-cy Phone No 407.205.3778
Fill in fee simple Title Holder on next page (if different E-Mail Jpapp@nidycompany.com
from the Owner listed above) State or County License CBC 1261000
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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S!UPP.. NTA.LF. CUCTION;„LIEWRVATIONTRLEME
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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: N/A
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AF,FIDVIT: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 conflicts with any applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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
n 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 Contractor-or-Owner Builder as applicable
STATE OF FLORIDA j II
COUNTY OF 3e i(1'C�l
Sworn-t�,(or affiirr)ed)and subscribed before me of Physical Presence or Online Notarization
this�day ofT£ f ( 2Q��4X
Name of person making statement. ; O—C/L 5:te Cfe./) sof-)
Personally Known OR Produced Identification I
Type of Identification Produced i
(Signature of Notary Public-State of Florida)
11,, ''11
A Commission No.T (Seal) ;�;'SyPye, MICHELE KEMP
;M, ;Notary Public-state of Florida
Commission # HH 40033
M Commission Expires
� September 07, 2024
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