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All APP~ICABLE INFO M~T BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: () 5/0'//22 Permit Number:
I I --------
Building Permit Application
Planning and Development Services
Building and Code Regulation Divisio n Commercial -----Residential __ · __..{ ...... / __
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding ___ _
PERMIT APPLICATION FOR:
Address: 3q1;3 Dur1e Side Dr , Pt Prerce ,, Pl 311</~
Property Tax ID#: i 92? -55(i -C>C):30 .-.. CJC'J() -O Lot No. 27
Site Plan Name : --------------------------Block No. __ _
Project Name : H111r1~ berger: wmg~
New Electrical Meter ____ Second Electrical Meter ______ (Affidavit required)
Additional work to be performed under this permit -check all that apply :
~echanical 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 : $ /(2 1 (JQ{) Utilities: Sewer _ Septic Building Height: ___ _
Name [AJ'7J illt'\S e~e.r --, ;. .. ··-, : .,,-.,L . -. ~a~e:.,,_·-,;-1L_"1_fS_' ~U_rf_c.{~~---,----,-~--.--=:--
Address : g1 ~z: Dune 5'rde--1 Dr · _r,:, .. I .. ·-:~:'."".:~
1
.~'f~ C~m~a~~r Y~P,9 i ,1%'aciqtef Reno WWJ thr,p L
City: HuJch r nsdn -:rs {;r,11 /J1 •. ,,,, I State :~l 11 . -~W.rui SJ I 'l IO LI 1. ~+ s"fr ed
Zip Co~e : 3<(1t/q Fax: :.··--· ,~ .. ..i, .. ~ City : Po rt Pt 'crce State : B
Phone No . ______________ E-Zip Code : 3 11 gJ_ Fax: ______ _
Ma il :_____________ PhoneNo 772 -70!-50'72
Fill in fee simple Title Holder on next page {if different E-M ail J pev,c Y @ J ~ft\ It C • [Or'r)
from the Owner listed above) State or County Licen se CRC 133 I T~-1
If value of constructi on i s 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.
DESIGNER/ENGINEER: 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: Addres-s: ______________ _
City:------,-----------Zip: _____ Phone: _________ _
Name: _______________ _
Address: _______________ _
City: _______________ _
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 Co~nty f!Jakes no representation that is granting a permit will authorize the permit holder to build.the subje~t ~tructure
which conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or proh1b1t 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, i n 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 attorne before commencin work or recordin our Notice of Commencement.
s;g~ Owoec 8"Hdec a, appi;cable
STATE OF FLORIDA ,
COUNTYOF Sf. [0 C1 e
Swo13!.1£. (or affirmed) and subscribed before me of
this -=....E'day of :1YlaJteh . 2021,.by
/ Physical Presence or __ Online Notarization
Name of person making statement.
Personally Known ___ OR Produced Identification .f._
Ty pe of Identification Produced-+'\D...._ _______ _
(S ignatu o otary Public-State of Florida)
Commis sion No.~~ 3 ~seal)
REVIEWS
DATE
REC EIVED
DATE
I CO MP LETED
ev
FRONT
COUN TER
ZONING
REVIEW
I.~ JULJ•~-.•i ::J MYCOMMISSION#GG338055
\l\ 0if/ EXPIRES: August 10, 2023 ••. ' ,,,,,. Bonded 11wu Nay Pl.mlc~
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVI EW