HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: 02/17/17 Permit Number:
• _
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 home
PERMIT APPLICATION FOR: Fence
PROPOSED IMPROVEMENT LOCATION:
Address: 109 Riverview Drive
Legal Description: Lot 22,Top of Watton Subdivision,according to the map or plat thereof,as recorded in Plat Book 7,at page 1,of the Pubic Records of St.Lucie County Florida
Property Tax ID#: ���/9�- `�2 a — � Lot No.22
Site Plan Name: Block No.
Project Name: Cushman Enclosed Fence
Setbacks Front r Back: Right Side: Left Side: &ii
DETAILED DESCRIPTION OF WORK: s
Enclosed white wood picket fence on front of side yard with gate facing side porch of house and
another gate which will lead to back portion of lot 22. Height offence is 14feet.
=1
CONSTRUCTION INFORMATION:
Additional work toe e Orme under this permit-check a appy:
HVAC E]Gas Tank E]Gas Piping _Shutters Q Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$�� 100. � Utilities:qn Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Frank P Cushman Name:
Address:109 Riverview Drive Company:
City: Jensen Beach State:FL Address:
Zip Code: 34957 Fax-772-207-5498 City: State:
Phone No.561-718-7394 or 561-603-1302 Zip Code: Fax:
E-Mail: malgia777@gmail.com Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or ounty License:
If value of construction is$2500 or more,a RECORDED Notice of C mencement 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 BONDING COMPANY: _ZNot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLO D STATE OF FLORIDA
COUNTY OF uC—`� COUNTY OF-
The forgoing instr ent was acknowledge( b fore me The forgoing instrument was acknowledged before me
this day of C: 20 Eby this day of 20 by
( '�� asi�unc�n
(Name of person acknowledging) (Name of person acknowledging)
(Signature of N 'tJry Public-State of Florida) (Signature of Notary Public-State of Florida)
V �,Oly PV9 N
Personally Knolry o �'�. C �M#Jgfication Personally Known OR Produced Identification
aF u is- tate of Florida Type of Identification Produced
Type of Identi dao dice
V My Comm.Ex it �QM�ay,27,2019
Commission ',,,„° ,, RnnBa�lth p g Commission No. (Seal)
rough NatloffaPNbtary Assn.
F'
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS