HomeMy WebLinkAboutFENCE - RESIDENTIAL All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED C1
Date: ler-. 7 '11� Permit Number: �l1 (0—go
Building Permit Application JUN 2 9 2017
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: eNf C t
PROPQSED INP,R®,�, UEM,ENT L®CATIQN:
Address:I0 3;�/ �� � S�f I I`7 t' �2C�-� �f WI,
Legal Description:
Property Tax ID#: LV ����/ Lot No.
Site Plan Name: Block No.
Project Name: Y&&A, � J
Setbacks Front Back: Right Side: Left Side:
IMTAIILIEJPJ,gETS�-C'.,Rll�.irT,lgN tJF WORK:
L e_� � h
C®NSTR+UCTION INFORMATI+
Additional wor tobepertormed under this permit-check.all that appy: ;
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost;of:Construction: $ A /4-0 0- 0 0 Utilities: Sewer Septic Building Height:
OWNER/LES-1SE C®NTRA OR:
Name: ,,11Al
Address o2:✓f ./tyi�' C6mpany:.O /` •\ i Z�10
+city:' i�%XY�iL State Addres's::
Zip`Code ' Fax: City: ;7--f;7--f State: �
Phone No.# i Zip Code: `f(� - Fax: ���- Y6?'/S/[
E-Mail: Phone No
Fill in fee simple Title Holder on next page(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.
`PPLE!\/IENT' L C®'NS`�1'R�EJ' ION LIEN L,�11h1 I.N�FORf1lIA1'IOIV:
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:
OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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
commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contcacte oras Age t`for Ow�:ne Sfgnatue o�•`fdiCon,,r=act�_orr/Li ense Holder
STATE OF FLOR STATE OF.FLORID l
COUNTY OF Z. Luj i c- COUNTY OF �-. C✓
The forgoing instru t was acknowledged before me The f going instri ent was acknowledged before me
this day of 20j7 by this day of u.�.s2_� 20�A-
�7 by
„ + J
(Name of person acknowledging) (Name of person acknowledging)
�(o , &4a aL- �__ .Q
4'y's
Signature of Notary Public-State of Florida (Signature of Notary Public-State of Florida )
� �uNllui/r�j `` gRINA
SABRIIVA L. BLACK `\\%` g(�INA1, q iiia// ABRIfiI�LACK §1 p, ( Bis/
Personally Known I/ OR Produ �fe /// Personally Known OR Produced��en fo � �• �
. , �—
Type of Identification ;•�o FpA $ Type of Identification
Produced _1 :444e 9 o •
�oR,• Produced
� f95337 195337Commission NoH533 i$ �F —
q�
ii99`p• ndeUnd ;�••�Q�\A ��i99`.o'�0� lkide�+��.•'Q���
REVIEWS FRONT ZONIERVISOR PLANS VEGETATION SEATURTLE NWAGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Re—v.