HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 , Permit Number:
RECEIVED
Building Permit Application
Planning and Development Services MAR Z 12017
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 6//
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Fence
PROPOSED IMPROVEMENT LOCATION:
Address: /6 96k-Ay 'r 1 --- ✓�
Legal Description:44Lyl nT&_L /-S S< -�O4✓ ��-/3
Property Tax ID#: WL 201- 001-2- a O a_3 Lot No.1-;'-13-1
Site Plan Name: Block No..5-
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
5--W'o I S
CONSTRUCTION INFORMATION:
Additional work toe nerformed under this permit-check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters F�Windows/Doors
11 Electric 0 Plumbing Sprinklers ElGenerator E]Roof
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
o a-
Cost of Construction:$VO 0 0• Utilities:0_Sewer El Septic Building Height:
OWNER/LESSEE: ??11 CONTRACTOR:
Name Z•.9i-'r'-)!35�' Name: Scott Peters
Address: YJ O 2 Scc� 'w'ca b A V-e— Company:All Indian River Fence
City: f4 •P 1Q-rC_"'_ State:_F_l' Address: 790 SW Airoso Blvd.
Zip Code.-314 cl t Fax: City: Port Saint Lucie State:FL
Phone No. / y Zip Code: 34983 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.
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:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced priorto the issuance of a permit.
St.Lucie County make no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con Act wttt any applicable Home Owners Association rules,bylaws gr 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,t 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.
.2)Le'_t�
Signature of Owner/Agent/Lessee Signature of Contractor/license Holder
STATE OF FLORIDA STATE OF FLORIDAp
COUNTY OF a L,n i e_ COUNTY OF � Lw6e_
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this•.(4._,day of n. 20 L- by this �o day of VVk&A_el &, .20V_1-k by
&A-Nk6
(Name of person acknowledgin } (Name:of person acknowledging)
(sl atu7vVKn
N to Pub t -S to of Florida) (Signatur N t ic-State of Florida
CASEY D FRENCH
Personawn_ �Oi; ucedJdenti isatin Personally Known �� t ,4 c 4 !d of �lr _swe of Flori
Type of identification P"odKeeaL., CASEY D FRENCH�Typeof Identification Produ _ a e = 2 '
Rv o-
°� Notary Public State of FloridaN," Commission # FF 069924
Commission No:�— _ •_ My Qgeal)Expires Dec 1.2017 Commission No. °F i°�'�` %Q41 hrough National Notary A
:N•" o Commission# FF 069924 :S
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Revised 07/15/2014
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