HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE CO PLETED.FOR APPLICATION ----- ..
ION TO BE ACCEPTED
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Date: Z_, ' / ' L% o ermit Number: l
:ppe^� N ..
RECEIVED
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V. JUNI J: 8 2021.
Building Permit Application-
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Planning and DevelopmentSt, Lucie County
Services Per
mitting
Building and Code,Regulotion Division Commercial Residential.X
2300 Virginia Avenue,:Fort Pierce. FL 34982
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Phone: (772) 462-1553 Fax: (772) 462-1578 .. .
PERMIT APPLICATION FOR:.MOC11Ca::S Hurd
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Address: 10725 S Ocean Drive Unit # 421 Jensen Beach, Florida 34957
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Property Tax ID #:451.1 502 0143.000 oNo:
Site Plan Name::Hurd Block No. Q26
Project Name:Hurd:. - -
Installation: of a new 3000 PSI concrete slab_ with fi .ermesh @.4' in thickness with I 0) wire mesh mat and::
(1) # 5-rebar:with.6" x 6" thickened: edge, approximately: +/- are:feet. .
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New:Electrical.IVleter Second Electrical Meter.::-.
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Additional workto be performed under this permit —check all that apply:
Mechanical _ Gas Tank _.Gas Piping.. _ Shutters — Windows/Doors _ Pond
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Electric _ Plumbing _ Sprinklers _ Generator= _ Roof Pitch
77
Total Sq. Ft of Construction: BOB:+/' Sq.'Ft. of First -Floor:
9,000:00 .
Cost of Construction; $ Utilities: Sewer Septic Building. Height:-
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Name Monica, SHurd
Name::Robert E .Burns
10713'State Route.
Address:" :.
Company:: Burns and.Sons Concrete, lnc
City: Edon, Ohio.State:
Address: Post: Office Box # 2335 . .
43518
Zip Code:: Fax:
Palm ClFL
City: ty: State:
....
Phone No.419.2121818..
.
34991 ............
Zip Code:. Fax:
E-Mail:
7
Phone No 72 260 3726
Fill. in fee simple Title Holder on next page (if, different::
E-Mail BurnsAndSonsConcretelnc@grnail:com
. .. .. .......
State or County License25364
..from the Own ..
eraisted above) .-
If value of construction:is 2500 or more, a RECORDED Notice of Commencement is required.:
If value of:HAVC is $7 0. 0 or more,,a RECORDED Notice of.Commencement is:required. ..
Milli.rr
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 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.
Lud County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender qr 4n ay before commencirIg w k or recording your Notice of Commencement.
ITMnaftlni viii'gr/ Lessee/contractor asgent for Owner
Si n6ltluf/re of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF saint Lucie
COUNTY OFSalt Lucle
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
x Physical Presence or Online Notarization
this 17 dayof DUNE , I , 2020 by
(1DJbL_a_+[LkYr1
this—"\ dav of DUNE 42!11 0 2020 by
- FL�+ A 6-urns
Name of person making statement.
0 n making state,
Name o n making statement.
Personal Know duce X
C
Pers nally Kno x I AU U WWANS
PAV
Type of dent! a ion MY COMMISSION# GG 248769
V c tio er-
Typ of Ident tion .1 MY COMMISSION # GG 248769
Produc a r ORI DRIVE -EXPIRESs Sante'berlS, 2022
N
Pro uced EXPIRES: September 18.2022
WtiiIyPubkqWmnbm
N-U, Notary Pubk nderwdtets
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida
Commission No.. GG 248769QQ (Seal)
Commission No. GG 248769 (Seal)
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