HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t
Date: l' I� 1 Permit Number: 1O
Building Permit Application JUL a 9 200
Planning and Development Services , 1,r�
PEF?iP!'Pl"i1w43
Building and Code Regulation Division St. Lucie Ginty, FI_
2300 Virginia Avenue,Fort Pierce FL 34982 lam/
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Fence
PROPOSED IMPROVEMENT LOCATION:
Address: b ns l r-6 5d /0)V 'L
Legal Description: Ply y Ar'y
Property Tax ID#: 5_4(J;_—ai L6 10 Lot No. -71"_
Site Plan Name: Block No..6-9
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: , '
L;✓1 r /P, /S '
on
CONSTRUCTION INFORMATION:
Additional work to be Derformed under this permit-check a appy:
HVAC L_J Gas Tank E:]Gas Piping _Shutters Windows/Doors
FlElectric 0 Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
/Cost of Construction:$ 435'-J — Utilities: _Sewer OSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name A4ar 7o Name: ScottPeters
Address: ZV6 Sw z'roso 134J. Company:All Indian River Fence
City: /0 S I- State:Ft. Address: 790 SW Airoso Blvd.
Zip Code:_3 V 5i 9>3 Fax: City: Port Saint Lucie State:FL
Phone No. ')'f?(o SS(, /$`f9 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 prior to the issuance of a permit.
St.Lucie County makeno representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict witt 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 t 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,wails,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/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 6 f- L SL� COUNTY OF .<4-
The
4–The forgoing Instrume was acknowledged before me The forgoing Instrtlreat was acknowledged before me
this �day of `,.�\�� 2p I2_by this L day of J�1�„ .2iJj by
(Name of person acknowledging) (Name of person acknowledging)
(Signatur otary Public-State of Florida) I (Signature �ary Public- of Florida)
Personally Known OR Produced ld ntificationf I Personally Known OR Produced Identification_L---
Type of Identificai°n,Pspd cert is Type of Identificatio Pm
CATHY J ROBERTS aY p� � CATHY J ROBERTS
Commission No. i ! oa -PulBisal�tate of Florida Commission No. '� jV�al�State of FloJ
Commission#FF 221708 Commission#FF 22170
Pc 10 2019 =;� ac` NI Comm.Expires May 10,2
Bonded through National Notary Assn. '''�°�� Bonded through National Notary
Revised 07/151
REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS �
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