HomeMy WebLinkAboutBuilding Permit Application/ ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �7 Q - Of"
`=I Date: Permit Number: —
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JAN z z rur<
Building Permit Application P�phWi'; iING
Planning and Development Services Sr•Ducie Cour F`
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPLROVEM:ENT-LOCATION:
Address: 2809 South Brocksmith Road
Legal Description: Subdivision of Mcnurlen farms Blk 3E 1/2 OF LOT 11 (4.78AC)
Property Tax ID#: 2320-501-0042-010-6 Lot No.11
Site Plan Name: Sexton polebam/Carport Block No. 3
Project Name: Sexton polebam/Carport
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION'OF WORK:
4in 3000#fibermix concrete slab. building a 30x30 carport with attached covered walk to
residence. meteal roof. Electrical lighting as noted in plans.
CONSTRUCTION INFORMATION.
Additional work to be nprtormed underd this
permit–check all appy:
❑HVAC Gas Tank Gas Piping _Shutters Windows/Doors
_ ❑ p g ❑
EElectric Plumbing Sprinklers ❑Generator R1 Roof Roof pitch
Total Sq. Ft of Construction: 935 sq ft. S . Ft.of First Floor: 935 sq ft
Cost of Construction:$ 8800.00 Utilities:'n Sewer Septic Building Height: 9'4
01"NER/LESSEE. CONTRACTOR:
Name Brian Sexton Name: Owner Builder
Address: 2809 South Brocksmith Road Company:
City: Fort Pierce State:Fl Address:
Zip Code: 34945 Fax: City: State:
Phone No. 772-370-3668 Zip Code: Fax:
E-Mail: firemedic0369@gmaii.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.
=SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION::
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name: N/A
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: NIA Name: NIA
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 recordin r Notice of Commencement.
s
Si ture Owner see/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA ISTATE OF FLORIDA
COUNTY OF ---,+ L06--e— COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowl ged before me
this day of c Ca i' rl 20 Eby this day of 20 by
r
(Name of person acknowledging) (Name of person a owledging)
(Signature of'Notary Public-State of Florida) /Peonally
a of Notary Public-State of Florida)
Personally Known OR Produced Identification Known OR Produced Identification
Type of Identification Produced entification Produced
��;r�.... KELLY-MACHADO
Commission No. =r ;.Commiss(OGA04436 Commission No. (Seal)
GM.
00 4430 s;j =Expires September 15,2020
nce80o-38r1U19
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE 41
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