HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAPLf INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �' / Permit Number:
;..;_ RECEIVED
Building Permit Application AUG 11 2697
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: 70 y
Legal Description: /-./fie we'ad Poy-A- U»; q - 5/4 // 4o-r-5
PropertyTax ID#: /-30/ - 6// - 0.a O q - 0-00 - V Lot No. s
Site Plan Name: Block No. //0
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: y ' cy
0..n i.re/C cvc �
y! !r<i'�I, C11�in L.inK /=zn<< � CrTin� a.7 �'!� z �rOviT .•'�byy
P";J/ Own S%of / � r � 5 PP;nj /O
l3e�or z
CONSTRUCTION INFORMATION:
Adclitional work tobene orme under this permit-check a appy:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers q Generator Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ /_S60m�0 Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name 114circ ct."d Arn.i Ro c.zkbs K Name: Scott Peters
Address: 670 pe-k7•, �/ L-r► Company:All Indian River Fence
City: F7- /o/o- c _ State: F/ Address: 790 SW Airoso Blvd.
Zip Code: 3 Y9 SI Fax: City: Port Saint Lucie State:FL
Phone No. 7,--'D,- VJ 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.facie 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
commencina work or recording our Notice of Commencement.
Signature of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIPA
COUNTY OF - / fG; COUNTY OF 3 G vc
The forgoing instrument was acknowledged before me The fo oIng instr ent was acknowledged before me
this I(clay of 21,1 i1_by this day of�� .20(.A by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of •",11I,I ' S t f ior, a j (Signatureid*ary Public-State of Florida)
•.,�PµY P . CATHY J OSl; TS I
Personally Kn s ;0> �} 1 Personally Known ro uc
Type of Identif a t�Ced(`nmmIss1g i) Type of Identificatr'n3�
nfF2$1788 ;2
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�� My Comm.Expires May 10,2019 = '•c Commission#FF 221708
oF�.. Commission No.
Commission '"�I��_Bo through kft@Notarp Assn.b, y Comm.§(3140 May 10,2019
' �,'•� Bonded through NationaiNotary,4ss .
Revised 07/15/2014
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