HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE 1INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: , < . Permit Number:
ERECEIVED
Building Permit Application21 228
Planning and Development ServicesBuilding and Code Regulation Division unty, Permiµin^
2300 Virginia Avenue,Fort Pierce FL 34982
.Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line ` ,
PROP,,OSEDIMPROVEMENT LOCATION
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Address: 310 EAST EASY STREET FORT PIERCE, FLORIDA 34982
Legal Description: INDIAN RIVER ESTATES-UNIT 02-BLK 6 E 150 FT OF LOT 72-LESS N 18 FT-
AND E 150 FT OF LOTS 73 AND 74(MAP 34/11S)(OR 1392-2915:2826-1064)
Property Tax ID#: 3402-603-0049-000-9 Lot No. 72
Site Plan Name: M J STEWART Block-No. 16
Project Name: MIKE&JEAN DREAM
Setbacks Front 40 Back: 100 Right Side: .25 Left Side: 80
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DETAILED DESCRIPTION SOF WORK �' � ti :�
� s a_��� } '.4•'., ,Z.,s�.�j. ^"_tr:,{�A rs��.. b ,is :,G.t ,: {� «r
4'x 40' Extension Added to Driveway
2,500 PSI Concrete with Fiber Mesh A Min. 4"Thick
CONSTRUCTION INFORMATION }
., _, � ,�,� �, ^ ter, °t' ,..yk., ,• ,,..��..,
,.d itiona work to e e Orme under this permit—check a appy:
OHVAC Gas Tank' Gas Piping _Shutters Q Windows/Doors
Electric ElPlumbing OSprinklers E]Generator Roof Roof pitch
Total Sq.Ft of Construction: 160sq ft Sq.Ft.of First Floor:
Cost of Construction:$ 1,600.00 Utilities:OSewer Septic Building Height:
®WN',ER/LE55EECONTRACTOR
Name MICHAEL&JEAN STEWART, Name: JOHN RODGERS'
Address: .-3)0 Company JOHN R[O�DGERS CONCRETE `
City: FORT PIERCE i State: FL Address: orb Aq)1'Y1S U�t
Zip Code: 34982 Fax: City: FORT'PIERCE State: FL
Phone No. 772-528-8545 Zip Code: 34982 Fax: 772-465-3827
-E-Mail: Phone No. 772-201-8165 OR 772-240-5710
Fill in fee simple Title Holder on next page(if different E-Mail: RODGERSCONCRETE@GMAIL.COM
from the Owner listed above) State or County License: 19377
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: MICHAEL&JEMSTEWART Name: Jew"mmeRs
Address: 310 EAST EASY STREET FORT PIERCE,FLORIDA 34982 Address:
City: FORTPIERCE State: FL City: State:
Zip: 34982 Phone n2s284545 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
cornmencinIg work or recording our Notice of Commencement.
Signat a of Owner/ essee/Contra or as Agent for Owner Signatur of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF4. COUNTY OF
The fo oing instru ent was acknowledge efore me The f r oing instr en as acknowledge before me
this day of 20by this day of 20 by
Name of personXakird statement Name of pers making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification "
Type of Identification Type of Identification
Produced Produced
ILO
(Si natu of Nota Publi - a (Signature of N
,� ; KAREI,} �IIELSEN ;� yp�a� KAREN S. NIELSEN�
Commission No. ,.�` °�s a of Floc Notary Public Commission N ! a, of FloriASeaiiry Public
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_* Commission # GG 207484 =* +, Commission # GG 20748,4
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o�,a My Commission Expires +�oFFto My Commission Expires
Jurin 12. 2 72
REVIEWS O Too"p ZONING SUPERVISOR• PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17