HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: September 26, 2017 Permit Number:
s'
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 El
PROPOSED IMPROVEMENT LOCATION:
Address: 8274 Sandpine Circle, Port ST Lucie, FL 34952
Legal Description: LAKE LUCIE ESTATES PLAT NO. ONE LOT 28 (OR 1143-532; 3670-730)
Property Tax ID #: 3426 703 0042 000 1
Site Plan Name: Jones Fence Install
Project Name: Install PVC Fence
Setbacks Front 25+' Back: 24"
Right Side: 24° Left Side: 2_4"
Install 124' LF of 6' tall PVC privacy fence with 1- 6' walk gate.
Lot No. 28
Block No.
CONSTRUCTION INFORMATION:
Additional work to be pe orme un er this permit —check all appy:
❑HVAC E] Gas Tank E]Gas Piping _ Shutters ❑ windows/Doors
11 Electric ❑ Plumbing Sprinklers E Generator ElRoof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 4.770.00
Sq. Ft. of First Floor: _
Utilities: Sewer iSeptic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Pauline Jones
Name: Darrick Bailey
Address: 8274 Sandpine Circle
i
Company: A Great Fence
City: Port ST Lucie State: FL
Zip Code: 34952 Fax:
Phone No.812-4230
E -Mail:
Address: 751 NW Enterprise Drive
City: Port ST Lucie State: FL
Zip Code: 34986 Fax: 408-0272
Phone No. 812-0223
E -Mail: info@agreatfence.com
Fill in fee simple Title Bolder on next page ( if different
from the Owner listed above)
State or County License: 23954
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
Name:
Address: -• --
City: -- - State:
Zip: Phone
MORTGAGE COMPANY: Nat Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE "TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address: -
City:
Address:
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 your Notice of Commencement.
/4'�
Signa a ner/ e e /Contractor as Agent for Owner
Signature Cont ctor/Lice Hol er
STA E OF FLORIDA
STATE OF FLORIDA
COUNTY OF --•
COUNTY OF ST --
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 26 day of September 201=7 by
this 26 day of September 20 C7 by
Derrick Bailey
Darrick Bailey
Name of person making statement
Name of person making statement
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
— QL4 / 'Zz�z
Produced
a�_J�
(Signature of Nota bli tate o Florida j
[Signature of Notary P is -State of Florida )
Commission No G127618
C AL Y BISHOP
GG 7 `' CRYSTI '�'
Commission No. M ISHOP
;;
MY COMMISSION # GG127618
='.` MY COMMISSION # GG127518
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t'�o:i •' EXPIRES July 24, 2()21
S ivily 24, 202!
REVIEWS
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VEGETATION
SEA TURTLE
MANGROVE
COUNTER REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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