HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE C
Date: 5 "
ED FOR APPLICATION TO BE ACCEPTED
Permit Number: f.,e-)5 — 0a�9
SCANNED
BY
St. Lucie County
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
RECEIVED
MAY 10 2019
Permitting Department
St. Lucie County
Residential X
PERMIT TYPE: CONCRETE SLAB
PROPOSED IMPROVEMENT LOCATION:1125 NETTLES BLVD JENSEN.BEACH FLORIDA 34957
Address: 1125 NETTLES BLVD JENSEN BEACH FLORIDA 34957
Property Tax ID #: 4502 501 1312 000 8
Site Plan Name:
Project Name: SHATT SLAB
Lot No.1125
Block No.
I DETAILED DESCRIPTION OF WORK: rZ4 Y / oln , I
INSTALLATION OF 1175 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
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction: 1175
Cost of Construction: $ 10,900.00
Gas Piping
_ Sprinklers
Shutters
Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State: _
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Address:
City:
Zip: Phone:
BONDING COMPANY:
Address:
Zip: Phone:
_Not Applicable
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 YO R NOTICE OF COMMENCEMENT."
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Sign of Owner/JL see/Contractor as Agent for Owner Signature of Contractor/License Holder
OF OffrY OF '(+01,_1
The forgoing instrument was acknowledged before me
this IR(a_�day of_ 041,11 r 20If by
Name of person making(�Eatement.
Personally Known _ZO R Produced Identification
Type of Identification
Sig ature of Notary Public- State of Flori
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Commission No. Ft=9F/5yq • . *MY COMMISSION# FF
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STATE OF FLORIDA
COUNTY OF snnarwaE
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Name of person making statement.
Personallyown x N OR Produced Identification
Type of Id ntific_qtinr>`
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ev. 217/19