HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/15/2017 Permit Number: l Oq0
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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 X
PERMIT APPLICATION FOR: Fence
P�R { FOSEDIrM'PROUEMENT�LO`CATION.& ..'" g
Address: 5002 SANIBEL AVE, Fort Pierce, FL 34946
Legal Description: LAKEWOOD PARK-UNIT 12-A-BLK 175 LOT 1 (MAP 13/13N)(OR 3896=759)
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Property Tax ID#: 1301-615-0154-000-9
Lot No.
Site Plan Name: Block No.
Project Name: New Fence
Setbacks Front Back: Right Side: Left Side:
DETAILED D135CRIPTIONF WORK
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�6' Chain link fence in back and 4" Chain link fence in front.
CONSTR���CTICIN INFORM. TIQNy�n��r�� i� � `� `
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Additionalwor to en er orme under this permit—check all apply: i! �'
HVAC _Gas Tank
-]Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers 1:1 Generator E] Roof
(Total Sq. Ft of Construction: 1560 S . Ft. of First Floor: 1560
,Cost of Construction:$ 1100.00 Utilities:n Sewer Septic Building Height: 9'
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N�ER%LESSEE � � ` �' " `. CONTRACQR�
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Name Angel Morris Name: Roderick Waller
'Address:3720 Tanager PL Company: Sunrise City CHDO, Inc.
City: Fort Pierce State:FL Address: 3550 Okeechobee!;
Zip Code: 34982 Fax: City: Fort Pierce State:FL
Phone No. Zip Code: 34947 Fax: 772-907-0420
E-Mail: Phone No. 772-201-2850
Fill in fee simple Title Holder on next page(if different E-Mail: rodwaller1@gmail.com
from the Owner listed above) State or County License: CGC1515114
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEIVIENT�A�L CONSTRUCTION LIENLAW INFORMATION
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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:
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I certify that no work or installation has commenced prior to the issuance of a permit.
$t. LucieCountyy makes no representation that is granting a permit will authorize the permit holder'to build the subject structure
which is in 0 tr ct with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencingwork or recordingvour Notice of Commencement.
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_Signature of Owner/Lessa/Agent Signature of ontractor icense 1-1.6
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STATE OF FLORID! STATE OF FLORID
COUNTY OF J� COUNTY CIF-
The
The forgoing instru ent was acknowledged before me The forgoing instruum,,en,t`was acknowledged before me
this�day of 20 aby this$day of 20 I'l by
(Name of person acknowledging) (Name of person acknowledging)
( ' at a of Notary Public-State lorida) gnature of Notary Public-St6 of Florida)
Personally Known. OR Produced Identification Personally Known OR Produced Identification
Type of Identificati Type of Identification Prod !.
;``µ� LASH State IMMUMURW
at Florida �'r�ir"n��.,� L SHAHNA INGRAM
Commission No. �• Notary P'���oal� Commission No. ,a°o' °,., /ICC
My Comm.Expi es Dec 20,2018 a Qui- I'AR ublic-State of Florid
s�►. off: Commission#FF 177249 '+° • �Ay'Comm. =xp es Dec 20,201
°;; Bonded through a ion"r;. :, .
Revised 07/15/
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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