HomeMy WebLinkAboutBuilding Permit Application i!
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ^ L
Date: Permit Number: O( • �'i 0
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 •/
PERMIT APPLICATION FOR: Fence
PROPOSED`IMPROVEMENT:LOCATION:
Address:
Legal Description: 0)=
Property Tax ID#: ��� O/— 00)9_6 D O J Lot No.
Site Plan Name: Block No.
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Project Name:
Setbacks Front Back: Right Side: Left Side':
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.DETAILED DESCRIPTION OF.WORK:
�{�O/acs /"acs /�aarca ori ��o�T of a vF7-h,� 3 �nit5
a/o r 9 *A %'Vic K Sid,-W&I K
CONSTRUCTION INFORMATION
Additional work to be nertormed under tis permit–check all that appy:
HVAC Gas Tank ❑Gas Piping CGeneratior
Shutters E]Windows/Doors
aElectric Plumbing Sprinklers Roof
Total Sq.Ft of Construction: SQ. Ft.of First Floor:
Cost of Construction:$_ 19000 Utilities: Sewer aseptic Building Height:
OWNER/LESSEE: .. . . : . .....,,. ..CONTRACTOR,,,..
Name VAL Flk WG LG Name: Scott Peters
Address: ;�'� 7 5 �; �� �0 �.J1/ Company:All Indian River:Fence
City: d r`�sT�(�t�-/ _State:f:7.1 Address: 790 SW Airoso Blvd.
Zip Code: !q Fax: City: Port Saint Lucie State:FL
Phone No. Zip Code: 34983 1 Fax: 772 878-8283
E-Mail: Phone No. 772 340-1045
Fill in fee simple Title Holder on next page(If different E-Mail:
from the Owner listed above) State or County license:#26030'
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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: Not Applicable
Name: Name:
Address: Address: !I
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 makeno representation that is granting a permit lilt authorize the permit holder to,build the subject structure
which Is In conflict witt any pplicable Home Owners Assoc permit
ru es,bylaws or and covenants that may restrict or prohibit such
structure.Please consult wit: your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,l do hereby agree that 1 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.
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Signature of Owner/Agent/Lessee Signature of Contractor/license Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY COUNTY OF
The forgoing instrutment was acknowledged before me The forgoing instrument was acknowledged before me
thlsL)L day of VQk> 21, daof
_ 2011.k by
(Name of person acknowledging} (Name of person acknowledging).
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(Signature of Notary Public-Stdte of Florida} (Signature of Notary Public-State:of Florida)
Personally Known OR Produced identification' Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
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,Ny p� LASHAHNA INGRAM .``MY:
PR°"��,•• '' ASHAHNA INGRAM
Revised 07/15/20 ,20;`A � Notary Public-State of Florida :, ? � Notary Public-State of Florida
° - Comm. fres Dec 20 20181' la My Comm.Expires Dec 20,20181
p' •.,?E mmission�#FF 7249 '
Commiss on#FF 177249 I� Bo i� 1
REVIEWS FR Nf'��° i Olibfi3lQthroug iSUPEM1460Rn�{ al
1 PLANS �E6ETIQry..�..4 ° ItI. caMAN ROVE
CO °REVIEW"'` 'REVIEW REVIEW REVIEW"`'g " " 'REVIEW
DATE
COMPLETE
INITIALS i '!
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