HomeMy WebLinkAboutBrouillard permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
1�4__ ��Ct�
Permit Number:
Building Permit Application
Planning and Development Services
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: Re -roof
PROPOSED IMPROVEMENT LOCATION:
Address: 10751 S. Ocean Drive B12 Jensen Beach, FL 34957
Property Tax I D #: 4511-311-0041-000-5
Site Plan Name:
Project Name: Brouillard Re -roof
Lot No. See attached
Block No. See att.
DETAILED DESCRIPTION OF WORK:
Q s1�in 1 Y. s:n o u 6Q c+enc cs I rc+.
`Send r c Metier "A -�" `wr-rK% .1 l:Uu'C .
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical — Gas Tank —Gas Piping _ Shutters Windows/Doors Pond
— Electric — Plumbing _ Sprinklers
Total Sq. Ft of Construction: 1�
Cost of Construction: $ 7 $
OWNER/LESSEE:
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: Sewer _Septic Building Height:
Name Myy-1'Z. '7W
Addresa(-)
City: Stat :Y-N
Zip Code: —LQ12=) Fax:
Phone No.Nrl_- V- Q-
E-Mail: t'n� b(ask I
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
ame:F
ompany:
City. State. �--
Zip Code: k-47-/ `i Z Fax:
Phone No -�
E-Mail State or County License �J i
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
L'
SUPPLEMENTAL CONSTRUCTION.LIEN LAW INFORMATION:
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
Name:_
Address:
City:
Zip:
Phone:
BONDING COMPANY: Not Applicable
Narne:
Address:
City:
Zip: Phone:
UwNtK/ LUN 1 KALTUR 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County 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 your Notice of Commencement.
Signature ofpwner/ Lessee/Contractor as Agent for Owner
STATE OF FLORID
COUNTY OF 1
Swo Ato (or affirmed) and subscribed before me of
ical Presence or Online Notarization
thisl ay of _ _, 2020 by
Name of person making statement.
Personally Known OR Produced Identification l/
Type of I ti icati n
ProducedN�f5 WC1`
(Sig ature of Notary Public- State of Florida )
t►1Y C+n No. CY?4THJAM, Ni1TT ( ea
19
lrWRES: January 22, 2022
DATE
RECEIVED
DATE
COMPLETED
se Holder
STATE OF FLORI
COUNTY OF . L-00Z
Sworn (or affirmed) and subscribed before me of
P cat PresenceeQr Online Notarization
this ay of if 7 I 2020 by
aAnmy) &DI&
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced �}f��y. na1 t 1
}-- r}Q f
of NotaryPublic- Stal F
�' CYNTH)AM.NEJTt 'till {Seal) i~I
EEXPIRES: January 22, 2E►22
FRONT I ZONING SUPERVISOR PLANS VEGETATION I SEATURTLE I MANGROVE
COUNTER I REVIEW REVIEW I REVIEW REVIEW REVIEW REVIEW
permi+
Continued 146C info for Mark Brouillard
Legal Description
11 37 41 FROM SW COR OF SEC 12-37-41 RUN N 89 DEG 55 MIN 14 SEC E ALG S SEC LI 774.41 FT
TO C/L OF A1A, TH N 23 DEG 49 MIN 31SEC W ALG SD C/L 2921,33 FT, TH S66 DEG 10 MIN 29 SEC
W 290.01 FT, TH N 87 DEG 33 MIN 17 SEC W 393.12 FT, TH S 89 DEG 57 MIN 13 SEC W 133.4 FT,
TH S 00 DEG 02 MIN 43 SEC E 20 FT, TH S 89 DEG 57 MIN 13 SEC W 451.56 FT, TH S 89 ❑EG 55
MIN 57 SEC W 84.04 FT, TH S 00 DEG 09 MIN 27 SEC E 387 FT TO POB, TH S 62 DEG 06 MIN19
SEC W 112.49 FT TO PC OF CURVE CONC TO N R OF 112.49 FT CA 27 DEG 54 MIN 12 SEC, TH ON
ARC OF CURVE 54.78 FT, TH N 00 DEG 05 MIN 05 SEC W 27.33 FT, TH N 89 DEG 53 MIN 44 SEC E
80.6 FT, TH S 49 DEG 28 MIN 56 SEC E 42 FT TO POB (1312) (OR 3430-730, 733: 3438-1310: 3537-
1385)