HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Q
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
12300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE:
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PROPOS'ED"INPROVEMENT'LOCATION '
Address: 9550 CARLTON RD
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Piroperty Tax ID#: 4203-231-0005-000-0 Lot No.
Piroject Name: CARLTON RD
DETAILED OESGRIPTION OF WORK:
REPLACE SHINGLE ROOF `
.CONSTRUCTION,INFORMATION:
Utilities: _Sewer _Septic Sq. Ft:'of First Floor:
Cost..of Construction:$ 2400 Total Sq. Ft of Construction: 3,911
FLOODPLAIN DEVELOPMENT PE: RMIT#or structures,exemptfrom Building Code that are.in1he
flood plain'."
N`onresidentia'l FarmBuildin
g: Temp:Bldg/Shed used exclusively for construction :
;:Mobile/Modular. for temp. construction office B1dg..inv6lved in",distrib:of electrlclty:
.Other. ' flood°Zane: BFE: Floodway? Y/N If Y,.
No Rise:Certificatevith supporting data attached?,•Y/N
,A'II other applicable state and federal permits shall Abe obtained prior to:Conmencernent of
'construction.
i.01NNER/LESSEE CONTRACTOR:
Name MICHAEL CONRAN Name:
Address:9550 CARLTON RD Company:
City: FORT PIERCE State:_ Address:
Zip Code:,34987 Fax: City: State:
Phone No.7723613227 Zip Code: Fax:
E-Mail:MICHAELSEANCONRAN@YAHOO.COM Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFpORMATION;:
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:
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 thepermit 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.
Iri 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. f yo tend to obtain financing,consult with lender or an attorney before
commencing work or re r in our Notice of Commencement.
Signage of O ner/ essee%Cont actor Agent for Owner Signature of contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF z COUNTY OF
The forgoing inspbunent was acknowledg efore me The forgoing instrument was acknowledged before me
this day o 20�by this day of .20_ by
Name of person making statement. Name of person making statement.
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Personally Known OR Produced Identification Personally Known OR Produced Identification
'Type of Identification Type of Identification
,Produced Produced
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(Sighafure o Notary Public-State of WIorida) (Signature of Notary Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev: 1/9/203.9