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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1
Date:'\1� 11 Permit Number:
• RECEi D SEP 132017
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: Building
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:
Erecting 2 matching 20' x 18' carport buildings on existing asphalt.
CONSTRUCTION INFORMATION:
Additional work to e e orme un er t is permit—check a app y:
❑HVAC Ei Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof 14.0 Roof pitch
Total Sq. Ft of Construction: 720 S . Ft.of First Floor- 720
Cost of Construction:$ 2,290.00 Utilities:n Sewer[IS e*ptic Building Height: 8.33'
OWNER/LESSEE: CONTRACTOR:
Name Robert and Saralee Murphy Name:
Address: Company:
City: Fort Pierce State:FIL Address:
Zip Code: 34946 Fax: City: State:
Phone No.954-649-2020 ���� Zip Code: 'Fax:
E-Mail:sadmurphymail@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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable,
Name:Robert and Saralee Murphy Name:
Address: 2491 Keen RD,Fort Pierce,FL34946 Address:
City: Fort Pierce 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 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 recording our Notice of Commencement.
ignature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFS�r- L-y--' e COUNTY OF
The fo4oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this l day of 5 t a'r ,20-a by this day of ,20_ by
S ar
Name of person maki g sta ment Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced 1, b i, Produced
(Signature of Notary P.ubli -State (Signature of Notary Public-State of Florida)
�1� DEANNAMARIE GNENS
Commission No. G�� :y"'v,'`. MY�'atPSION#GGo22023 Commission No. (Seal)
=*� EXPIRES:December 16,2Q2U i
PublicUndervrrters
B llv
ondaduNotary J
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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