HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST.BE COMPLETED FOR APPLICATION TO BE ACCEPTED u
Date: a� Permit Number:
RECEIV7D JUN 26 2017
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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: (7 3 3 d /,re r (_;, 6' :-- C 0 er-S 1— S 7
Legal Description: FAZ/I') i rQ��-�s C1 13l)e 9 1.5 t 3
Property Tax ID#: d'1 1 d - SO o- 6/5Y- 0 Z d— �— Lot No. �
Site Plan Name: Block No. Z
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: ?( 10 rsacL f: 241C VIA1 K
I1 6 HicJ/.
7h< /you J< a Ci,
pr�Pr f`Y Li +� e s� aNy 75A 1 �v�fK C9Q7-e d t�,< A,-jAT5,dc�, �hcQ �OLv
irp,ti gsolc P 07-e-:5 eAp.0--0�e. /o =-iia a,4a acposs t-he- /3cc-K
FCONSTRU'CTION'l N FORMATION:
Additional work tobene orme under tis -checkpermit a apply:
HVAC, L_J Gas Tank ❑Gas Piping _Shutters a Windows/Doors
Electric El Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
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Cost of Construction:$ 0 Utilities:D_Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name A hayt,,�ke_ih- /'fie S ORA Name: Scott Peters
Address: L)Y 3 ,;7 5,5- QA j eL5 C Company:All Indian River Fence
City: s5i e._ - 4- State: F-*� Address: 790 SW Airoso Blvd.
Zip Code: Fax: City: Port Saint Lucie State.FL
Phone No. N;i-;��C) 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: dame:
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 Count
yY make no represent tion that is granting a permit wilt authorize the permit holder to build the subject structure
which is in ontlict witt any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Pease 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 tender or an attorney before
commencing worts or recording our Notice of Commencement.
Signature of Owner/Agent/Lessee Signature ofContractor/License Holder
STATE OF FLORIQ6 STATE OF FLORIDA l �'C"Lu `
COUNTY Of 7V �2� G COUNTY OF
Thefo ging instru nt was acknowledged before me The for oing instrument was acknowledged before me
this day of . 21?11 by this day of /k a,1 .20-12 by
(R4ame of person acknowl ging} (Name of person acknowledging)
r. t,�
(Signature t ub'd-S(ist���f alitS}gnatu o to lis- tate of Florida)
vCASEY D FRENCH
i..� a tar ' ProducectRien�tif0tionf
Personally known P ' ed, 'JjFi'�4fonstate of Flori �' rsonatly Known 7 ,
* omm.Expires Dec 1,2 1 pe of idents€icatlOn Ei NotaryPublic.-State of Florida
Type of identification pra u .a.• , 4
OF nnr�
FLO�`� 924 - * a°c My Comm.Expires Dec 1,2017
r•71tit11 1
Banded rcugh National Notary As; mmission NO. CommiJ$E%Q FF 069924
Commission No
717Bonded Through National Notary Assn.
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
COMPLETE
INITIALS l