HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONim
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: 1 q 0 a, �q `-
____ Building Permit Application z
Planning and Development Services N rnt
Building and Code Regulation Division ar m c c
2300 Virginia Avenue, Fort Pierce FL 34982 h
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ov
PERMIT TYPE:
PROPQSED IMPkOVEMENTLOC4T10N
9
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Address: 1402 Hartman Road SCANNED
Property Tax ID #: 2417-233-0002-010-9 BY
Site Plan Name: Rethertord Home St. Lucie County
Project Name: Rethertord Patio Addition
Lot No.
Block No.
Addition of screened enclosure and roof to an existing slab. Replace Windows and sliding door. Re -roof existing structure.
Additional work to be performed under this permit —check all that apply:
Mechanical
Electric
_ Gas Tank
—Plumbing
—Gas Piping
_ Sprinklers
Total Sq. Ft of Construction: 816 existing slab to patio
Cost of Construction: $ 14,500
_Shutters —Windows/Doors
_ Generator _ Roof Pitch
Sq. Ft. of First Floor: BAS 1668 / PATA 816 / GAA 528
Utilities: _Sewer _Septic Building Height:
01tttNEFt%LESSEE; ,,,•'. .,. _ :> t.:s
CONTRACORi...
Name Daniel Retherford
Name:
Address: 1402 Hartman Road
Company:
City: Ft Pierce State: _
Zip Code: 34947 Fax:
Phone No. 772-224-9826
Address:
City: State:_
Zip Code: Fax:
Phone No
E-Mail: dpretherford@gmail.com
Fill-in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
It 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.
SUPPLEMENTAL"CONSTRUGTIOfU
LIEN L4W INFOi
M4TI0iV'g' M "'s" � 5 "
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
Not Applicable
N a m e: Javier Cisneros
_
Name: Vp r- ,Pht rJ Cr-
Address: olo A- del /a-ve-
Address: 1 coop De.
City: F fF efC4_ State: f C
City: L aKe z vai c 4
State: / L
Zip: Zc..i Yt, Phone Sl9-01lo,7q
Zip: (,Oo47 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signa a of Owner/ Lessee/ act r as A&nt for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA c p
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 20_ by
this_ day of. 20_ by
�CimpoO "A0th gAoo7T
Name of person making statement. U
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
ign ture of Notary Public-UState of Florida)
(Signature of Notary Public- State of Florida )
s=r
Commission No. '�' ^"..••
Commission No. (Seal)
HAHNA-RAHMING
;•: Ml'OOMMIggIONNG0275060
P'•fOl P'
O, 2022
REVIEWS
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PLANS
VEGETATION
SEATURTLE
MANGROVE
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COUNTER
REVIE
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DATE
RECEIVED
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