HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: a�\ �� Permit Number:
RECEIVED
Building Permit Application FEB 15 2019
Planning and Development Services ST. Lucie County, PermittinL
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR:—Bu}dinj- t\,,
PROPOSED IMPROVEMENT LOCATION:
Address: 2491 Keen RD, Fort Pierce, FL 34946
Legal Description: 36 34 39 That part of SE 1/4 of NE 1/4 MPDAF:
S 273 FT of W 375 FT of E 470 FT of N 20 AC of SE 1/4 of NE 1/4 (2.35 AC)
Property Tax ID#: 1336-141-0010-010-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION-INFORMATION:
Additional work toe vertormed under this permit—check all that appy:
HVAC Gas Tank F]Gas Piping _Shutters Q Windows/Doors
nElectric ❑ Plumbing Sprinklers E]Generator E]Roof Roof pitch
Total Sq. Ft of Construction: SQ. Ft.of First Floor:
Cost of Construction:$ -/UU. Utilities:0Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Robert and Saralee Murphy Name:
Address: 24clT 1, EC&W Company:
City: Fort Pierce State:FL Address:
Zip Code: 34946 Fax: City: State:
Phone No.954-649-2020 Zip Code: Fax:
E-Mail:sarimurphymail@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.
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.
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."
Signature of Own /Lesse /Contractor gent for wner Signature.of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this%5 day of 20 1A by this day of ,20_ by
�,t-,\ ems. m \A
Name of person making statement. I Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary ublic-State of Flor' (Signature of Notary Public-State of Florida)
,,•Y, DEANNAMARiEGIVENS
Commission No.1s'4*O = AISSION#GG 022023 (Seal)
Maj Commission No.
EXPIRES:December 16,2020
m:
'•.',Fg«;o?° Bonded Tfw Notary Public Underwriters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.