HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
0443-29 " y116 i �� Permit Nw
_ �
Building Permit Ap
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34992
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT TYPE: Concrete Slab
PROPOSED -IMPROVEMENT LOCATIONS
Address: 2164 Nettles Blvd Jensen Beat
Property Tax ID #: 4502 5010167 000 9
Site Plan Name:
Project Name:
Florida 34957
APR 16 9±9 I '
St"�ty, permittlno
SCANNED
BY
Residential x St. Lucie County
Lot No.164
Block No.
DETAILED DESCRIPTION OF WORK:
4" thick 70' x 22' 3000 PSI concrete slab with fiber mesh and a 4" thick 4' x 40' 3000 PSI concrete slab with fiber mesh.
JtCONSTRUCTION INFORMATION: -
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction � — Sq. Ft. of First Floor:_
Cost of Construction: $ tilities: —Sewer _Septic
i
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Albert Schroth
Name: Robert E Bums
Address:2164 Nettles Blvd
Company: Bums and Sons Concrete, Inc
City: Jensen Beach, State: _
Zip Code: 34957 Fax:
Phone No.
Address: Post Office Box # 2335
City: Palm City State: FI
Zip Code: 34991 Fax:
Phone No7722603726 DC-D5 • Q��
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the owner listed above)
E-Mail BumsAndSonsConcretelnc@gmail.com
State or County License 25364
it value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC 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 TITLEHOLDER: _ 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 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 JOB SITE BEFORE THE FIRST INSPECTION. EF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YnuR NnTIrF nF rnmmFNrrmFNT -
TSigrra p? 9W0 er%,Lessee/ ontractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF SAINT LUOE
COUNTY OF SAINT LUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 13 day of APRiL , 20_ by
this is day of APRIL 20_ by
ALBERT SCHROTH
ROBERTE BURN ,••gip+;"'••,,
Name of rson making at ` 'n • ; 811'OOMMISSION>iGG2487
Name of pers n makin MY COMMISSION#GG248769
EXPIRES: September 18.2022
Personally I' sown _ _*'R¢�{;f?t' Aa�rdiMsll�aREsSoUM rmftys
'•;�.... a EXPIRES: September 18,
Person ly Known X o" t tNmtplbBeU
Type of Ide tification
Type of Ide I icatl
Produced
Produc d
" i::� N IrQ��
(Signature of Nota////P����u 'c- St a of FI ri�T )_ �
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(Signature of No ry P...���li'''c���- to of a) ^
Commission Na. c!(Se
Commission Na. SaN,tYJY�I
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
I
DATE
COMPLETED
,O V. L/ 1/ 10