HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: • ' �1• a� Permit Number: 422
91r.LtUC
p RECEIVED
Building Permit Application MAR 1`4 2022
Planning and Development Services
Lucie Counbj
Building and Code Regulation Division Commercial Residential Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR:New 4"thick 3000 PSI concrete slab with fibermesh and one#5 rebar for manufactured home
P>;ROPOSED„I,, PROVEM-ENT LOCATION 718 Neftles Blvd Jensen-Beach,-Florida 34957Address:::7
Property Tax ID#: 4502 501 0904 000 8 Lot No.718
Site Plan Name: Block No.
Project Name: Kugler Home
D.ETAILED,DESCRIPTION OF WORK.,,,,,„ r,,,. ,;; 4, POP"
Approximately 1,725 sq. ft. of new 4"3000 PSI concrete slab with fibermesh and a thic ened edge with (1)#5 rebar.
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New Electrical Meter Second Electrical Meter (Affidavit require$
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CONSTRUCTION`INFORMATION
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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: 1725 Sq. Ft.of First Floor:
Cost of Construction:$ 14,662.50 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE.' �, p
°"'" "" � � � CONTRACTOR: '
Name Barbara Kugler Name: Robert E Burns / Vice President
Address: 7940 SW 173rd Terrace Company: Burns and Son's Concrete, Inc
City: Palmetto Bay State: FL Address: POST OFFICE BOX#2335
Zip Code:33157 Fax: City: Palm City State: FL
Phone No. E- Zip Code: 34991 Fax:
Mail: Phone No 772 260 3726 or 772 260 0776
Fill in fee simple Title Holder on next page (if different E-Mail BurnsAndSonsConcretelnc@gmail.com
from the Owner listed above) State or County License_ 25364
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
T, 6m%
DESIGNER/ENGINEER: —Not Applicable P 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 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 lender or an attorney before commencing work or recording our Notice of Commencement.
l�
Signature of Contractor-or-V
ner Builder as applicable
STATE OF FLORIDA
COUNTY OF SAINT LUCIE
Sworn to(or affirmed)and subscribed before me of x Physical Presence or Online Notarization
this 04 day of_ March 2022 by
Barbara Kugler
Name of person making statement.
Person y Known OR Pro iGced Identification X
Type o Identif' a io ProducedFlorida Drivers Licenses
(Signature of Notary Public-State of Florida)
;,�=•�:p•+P/��(�• AUTUMN N.BURNS
Commission No. GG 248769 (Seal) ,• ;,t MY COMMISSION#GG 248769
Pa EXPIRES:September 18,2022
B=W UN Notary Public gndelwrbrs
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 10/12/21