HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMP'_, ,'D FOR APPLICATION TO BE ACCEPTED
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Date: ' 3 l � 1 Permit Number:
if , c , - v< _ MAY 0 3 2019
Permitting Department
Building Permit Application St. Lucie County
Planning and Development Services SCANNED
Building and Code Regulation Division BY
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: CONCRETE SLAB
PROPOSED IMPROVEMENT LOCATION: 2154 NETTLES BLVD JENSEN BEACH FLORIDA 34957
Address: 2154 NETTLES BLVD JENSEN BEACH FLORIDA 34957
Property Tax ID #: 4502 501
Site Plan Name:
Project Name- SHATT SLAB
111 .
DETAILED DESCRIPTION OF WORK:
Lot No.2154
Block No.
INSTALLATION OF 675 SQ FT OF 4000 PSI CONCRETE SLAB WITH # 5 STEEL MAT @ 7.5" IN THICKNESS.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 675
Cost of Construction: $ 5,700.00
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: OWNER
CONTRACTOR:
Name MURRAY J SHATT
Name: ROBERT E BURNS
Address:24632 OVERSEAS HWY PO BOX 420488
Company, BURNS AND SONS CONCRETE INC
City: SUMMERLAND KEY FLORIDA State: _
Zip Code: 33042 Fax:
Phone No.305 900 8204
Address: PO BOX 2335
City: PALM CITY State: FL
Zip Code: 34991 Fax:
Phone No 772 260 3726
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail BURNSAND SONSCONCRETEINC@GMAIL.COM
State or County License 25364
If value of construction is $2500 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.
SUPPLEMENTALCONSTRUC.__N 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. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Lure of Own(r Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
rA
TE OF FLORIDA
STATE OF FLORIDA
COUNTY OF� ) O. (4VI
COUNTY OF sarrrwaE
The forgoing instrument was acknowledged before me
TheVginst e t c nowledg fore me
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this¢ day of rd 20A by
ay of 20
,
.• M L(yYYF A S' (n!�
Name of person makin statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally nown x OR Produced Identification
Type of Identification
Type of I entification
Produced
Produce
Stg Lure of Notar06blic- State of FI.WAEb) NICOLE HUDDLE
(Signature of Notary P of Flo NROURNS
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DATE
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DATE
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Kev. 211119