HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 614/18 Permit Number:
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Building Permit Application JUN 0 7 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie county, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Concrete
PROPOSED IMPROVEMENT LOCATION:
Address: 13017 S INDIAN RIVER DRIVE JENSEN BEACH, FL 34957
Legal Description: Legal Description
09 37 41 COMM AT PT OF INT ELY R/W FEC AND C/L OLD DEPOT RD
SD PT BEING PT OF CURVE CONC E,CA 03 DEG 44 MIN 49 SEC,R OF
2814.93 FT,TH NLY ALG SD ELY R/W AND CURVE 184.07 FT TO CURVE
Property Tax ID#: 4509-120-0002-000-7 END AND POB,TH CONT ALG SD ELY R/W N 25 DEG 52 MIN 00 SEC W
104.51 FT,TH N 66 DEG 33 MIN 35 SEC E 805 FT M/L TO WATERS
Site Plan Name: Dawn O'Grady EDGE,TH SELY ALG WATERS EDGE TO PT BEING 66 DEG 08 MIN 45
SEC E FROM POB,TH S 66 DEG 08 MIN 45 SEC W 810 FT M/L TO POB
Project Name: O'Grady Generator Slab (1.84 AC)(OR 3970-1073)
Setbacks Front37T Back: 393' Right Side: 97.6 Left Side: 5.57'
DETAILED DESCRIPTION OF WORK:
Install New 40" X 80" X 6" thick concrete slab for new 25 KW Generator. Owner Builder
,� S-0 o. CS 1. .
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit-check a appy:
HVAC FI Gas Tank ❑Gas Piping _Shutters a Windows/Doors
0 Electric ❑Plumbing O Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S�of First Floor:
Cost of Construction:$ $600.00 Utilities: Sewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name DAWN O'GRADY Name: I I Yn - .(-(2—
Address:1301
i2Address:13017 S INDIAN RIVER DR Company: �Ji 01
City: JENSEN BEACH State:FL Address: 49&
Zip Code: 34957 Fax: City: State:EL-,
Phone No.(954)805-1512 Zip Code: Fax:
E-Mail:rehabdogl@att.net Phone No. 7 T - 760-032-
Fill
60-032-
Fill in fee simple Title Holder on next page(if different E-Mail:,-6,4- tit gz () lir'tr_�a t, al
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Geylo(pv�n y 4 M - d u5
L'S
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _��Not Applicable MORTGAGE COMPANY: � Not Applicable
Name: Name:
Address: Address: iso:
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded 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 Commenceme
I /
Signatur of Owner/Lessee/Contractor as Agent for nerig ure of Contractor/License Holder
STATE OF FLORIDA TATE OF FLORID
COUNTY OF COUNTY OF
The fgr�oing instru ent was acknowledged before me Th g Inst�����t wa )acknowledge fore me
this ay of LV19_ 20 2l by th' day of_-+tt-� 20 by
Name of persnR
g statem nt Name of person making statemen
Personally KnownroducedIdentificati� Personally Known OR Produced Identification
Type of I ntifi atio Type of Iden ' ' ion/n
Produ d Produced L D L—
Y' kw"u, I&L"1�4
(Si ture o ublic-State of Florida ) (Signature of Notary Public-State of%66 1
Y pu USHEA L.GRMG
Commission NR ec �( IISSION#GG 080413
N9lo< Commission No.
EXPIRES:March 7,2021 ; 4�'��f�Pi,14AN4lR
f'OF Fly Bonded Thru Budget Nolan'Sernces t� F+:Itaq Pubk 3t:to of Fkxfd
,m,e. �aac Qd,18,201
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION wT
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17