HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1t �SCANNED Permit Number:
St Lude COUTO
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 Xx
PERMIT APPLICATION FOR: -Other
PROPOSED IMPROVEMENT LOCATION:
Address: 10751 S Ocean Drive
Legal Description: See Attached
Property Tax ID #: 4511-311-0011-000-6
Lot No.
Site Plan Name: Block No.
Project Name: Marlyn
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: r \--,P r0, � L
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Reconstruct carport roof and sunroom on existing concrete - Storm Damage Replacement
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CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit —check a apply:
OHVAC 13 Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
Electric 0 Plumbing Sprinklers ElGenerator Roof Roof pitch
Total Sq. Ft of Construction: (GMEk S . Ft. of First Floor: 1���(
Cost of Construction: $ ���C7`�� Utilities:OSewer Septic Building Height:_
OWNER/LESSEE:
CONTRACTOR:
Name Breck Marlyn
Name: Crystal Anderson
Address: 15 Darrow Place
Company: Olneya Restoration Group, L.L.C.
City: Poughkeepsie State: NY
Address: 4253 SW High Meadow Avenue
City: Palm City State: FL
Zip Code: 12603 Fax:
Phone No. 845-452-3088
Zip Code: 34990 Fax: 772-925-8417
E-Mail: breck.mar@hotmail.com
Phone No. 772-222-5019
Fill in fee simple Title Holder on next page (if different
E-Mail: Ilawrence@olneya.Com
from the Owner listed above)
State or County License: 4'
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If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. —
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S ,PV EIVIENTAL CONSTRlJCT10 N LAW INFORMATION
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DESIGNER/ENGINEER:
, _ Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name �A\�Ir"(
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Name:
Address:
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Address:
City:( 14-o-f Qcubpu
State:
City:
State:
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Zip: 33-R o -Phone-)
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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 vour Notice of Commencement.
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Signature o Owner/ Lessee/Contractor as Agent for Owner
Signature o Contractor/License Holder
STATE OF FLORIDA"
STATE OF FLORIDA
COUNTY OF \�Q 11r1
COUNTY OF
The forgoing instr ment was acknowledged before me
The forgoing instr ment wWSCknowledged before me
this,r day of 20A by
this � day of 20A by
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Name of person making statement
Name of person making statement
Personally Known � OR Produced Identification
Personally Known � OR Produced Identification
Type of Identificatio
Type of Identification
Produced
Produced
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
i
VEGETATION SEATURTLE
MANGROVE
COUNTER
REVIEW'
REVIEW
REVIEq
REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17