HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: mit Number:.
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division COfnrrlercial Residential .X
2300 Virginia Avenue,, Fort Pierce FL 34982 ..
Phone (772) 462=1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:.:
_. Joseph:A Carone:(TR)
PROPOSED IMPROVEMENT LOCATI;ON::
Address:. 234 Nettles Blvd Jensen Beach, Florida. 34957
Property Tax ID #:.4502 501- 0420 000:1 ;: Lot.No. 234
Site Plan Name: Block No:
Project. Name::. :.
F,"bETAILE'D DESCRIPTION.0F°1NORK.`';•
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22' x 60'-CM 4":ih thickness 3000 PSI concref with fib&tnesh slab=with one # 5.rebar::.
IINew Electrical:Meter Second Electrical Meter_
(Affidavit required)
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CONSTRUCTION INFORMATION -� ,,. ...., .. . , . .. �a . e. m , � � ,r i , � v.:, � -. „ ,.,�., � unaunyo��. rv�,z G��i w �•�
Additional work. to be performed under this permit —check all that apply:
'—Mechanical, -.-Gas Tank. _ Gas Piping .. _ Shutters _ Windows/Doors. _ Pond
.
Electric' _ Plumbing Sprinklers 'Generator _ Roof Pitch
Total Sq. Ft.of Construction: 1,320:Sq Ft. Sq. Ft of First Floor:
Cost of Construction:=$ // Utilities;. Sewer _Septic : :, Building: Height;:
OVI/NER/LESSEE: : ;.,'
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CONTRACTOR' .
Name, Joseph:A Carone-(TR) .::.
Name.Robert E.Burns
Address: 1113 Nettles Blvd
City: Jensen Beach State: FL
Zip Code.: 34957, Fax:
Phone No. E-
Company: BURNS AND SONS CONCRETE INC.
Address: . POST OFFICE.BOX # 2335
City: Palm City State: FL
Zip Code34991 Fax:
Phone No_772'260:0776:
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail_ BumsAndSonsConcretelncCa)gmail.com
State or County License 25264
it value of construction is z500 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 I_Wder or an attorney before commencine work or recordine vour Notice of Commencement.
Jgggure o ®wn'er% es'see -Contractor as Agent-for-OWner
STATE OF FL I
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COUNTY OF
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Sw r a e a
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of Physical Presence or Online Notarization
=c3edbefqr!LVe
thi ay
king statement. \
Name oFJ
Persona OR Pr u ed I
Type of n Produced
(Signature of Notary Public- State of Florida)
Commission o. )
;2o"pVP6�; AUTUMNN.BURNS
_*. MY COMMISSION # GG 248769
mA Qoa EXPIRES: September 18, 2022
°FF4° Bonded Tiw Notary Pubric gndenv brs
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