HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date-4-25--264,7 5il�1I 1� Permit Number:
RECEIV70 MAY 112017
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2.3001VirgM Avenpe,.Fort Pierce FL 34982
Phone: (_771)21462'-_'1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Fence
PROPOSED IMPROVEMENT LOCATION:
Address: 5503 Winter Garden Parkway Fort. Pierce, FL 34951
Legal Description: Lakewood Park Unit 12 BLK 160 Lot 18 (Map 13/12S) (OR 3203-2680)
Property Tax ID#: 1301-614-0108-000-9 Lot No.18
Site Plan Name: Block No. 160
Project Name:
Setbacks Front Back: Right Side: Left Side:
F,DETAILED DESCRIPTION OF WORK:
Installing Wooden Privacy Fence along back side of property and in front connecting to both neighbors
CONSTRUCTION INFORMATION:
Additionalwork toa performed under this permit—check all apply:
HVAC Gas Tank Gas Piping _Shutters 0 Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ J Utilities: []Sewer ElSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Jack Bullers Name:
Address:5503 Winter Garden Parkway Company:
City: Fort Pierce State:FL Address:
Zip Code: 34951 Fax: City: State:
Phone No.772-979-6050 Zip Code: Fax:
E-Mail:havefaith1211@aol.com Phone No.
Fill in fee simple Title Holder on next page f if different E-Mail:
from the Owner listed above) State or County License:
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 prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize thepermit 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 your Notice of Commencement.
S
Si ature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Ltd Ct - COUNTY OF
The forgoing instrurVent was acknowledged�efore me The forgoing instrument was acknowledged before me
thisJS"day of o, i 20 1 by this day of 20 by
(Name of person acknowledging) (Name of person acknowledging)
JJCA
Si ature of Notary P i State of Florida ) (Signature of Notary Public-State of Florida)
Per onally n OR Produced Identification Personally Known OR Produced Identification
Ty e of Identification Produced Type of Identification Produced
Commission No. 3qFr7Se*4Iyp��i�gteteofFio £o fission No. (Seal)
Justine SUllers
My Commission FF 11634
Or r08
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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