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Date: 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 X
PERMIT APPLICATION FOR: Fence
PROPOSED ,IMPROVEMENT. LOCATION:"
Address: 5615 Place Lake Dr, Ft. Pierce, Fla. 34951-3138
Legal Description: Portofino Shores -phase three-(PB43-40) lot 270 (or 3930 -1475
Property Tax ID #: 1312-503-0066-000-5 Lot No. 270
Site Plan Name: PLACE LAKE DRIVE Block No.
Project Name: Bank of America Trust
Setbacks Front 79 Back: 0 Right Side: 0 Left Side: 0
DETAI"LED DESCRIPTION"`'OF WORK:
Install 138' of 6' PVC Fence at rear of property I,r,? ITN Z 4' GA—1 t-�; opE-oo EAr-H 51 I)E
CONSTRUCTION
INFORMATION: -
Additional work to be nertormed under tispermit—check all h
HVAC Gas Tank []Gas Piping _ Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers ElGenerator E]Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 4487
SFt. of First Floor: _
Utilities: L=1 Sewer 11 Septic
Building Height:
'0.11VNER%LESSEE .
-CONTRACTOR:
Name Bank of America NA (TR)
Name: Ross A. Chambers
Address: 5615 Place Lake Dr
City: Ft Pierce State: Fl
Zip Code: 34951 Fax:
Phone No. 941-951-4128
Company: Adron Fence Co
Address: 1132 NE 12th St
City: Okeechobee State: fl
Zip Code: 34972 Fax: 863-763-8404
Phone No. 800-282-5172
E -Mail: mchele.m.charlet@ustrust.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: adronfence@live.com
State or County License: 18971
I If value of construction is $2500 or more, a RECORDED Notice of Commencement ilequired. �r.,-:V_�
C�LJ
SUPPLEMENTAL CONSTRUCTION LIEN.LAW INFORMATION:
DES GNER/ENGINEER: _ Not Applicable
Name.
MORTGAGE COMPANY: _ Not Applicable
Na
Address:
Add re s:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE OLDER: _ Not Applicable
Name:
BONDING MPANY: Not Applicable
Name:
Address:
City:
Address:
City:
Zip: Phone:
Zip: Phon
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
commencinfa work or recording vour Notice of Commencement. 7
as Agent for Owner I SignatGre of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF OKEECHOBEE
COUNTY OF OKEECHOBEE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 1 day of M GZIGL 20 4:Z -by
this ' day of MARCH 20 1.7 by
ROSS A. CHAMBiRS
Ross A. Chambers
(Name of person acknowledging)
(Name of person acknowledging)
REVIEW
REVIEW
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Personally Known _
ersonally Known}, OR Produced Identification
�
Type of Identification Pr ucq)JY"",PV 4, DOREEN ELARDI
ype of Identificatio
otar Pu :c - tate o orida
Y
,jos, P" �
, 1PAyall", DOREEN ELARDI
Commission No. _ • : •c My�g@�Rl. Expires Oct 21, 201
�.,,
ommission No. :�2�* Notary Pufaate of Florida
p�`.� Commission # FF 150067
11,40F. F ��'1 Bonded Through National Notary Ass
* * y Comm. xpires Oct 21, 2018
�`•� Commission # FF 150067
Revised 07/15/2014
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