HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
• RECE-IV LZE '
Building Permit Application
Planning and Development Services DEC 0 1 2017
Building and Code Regulation Division PERIMTTING
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Uo,tntj, F-L
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Fence
PROPOSED IMPROVEMENT LOCATION:
Address: 6504 palomar pkwy
Legal Description: LAKEWOOD PARK-UNIT 12-A-BLK 173-A LOT 12-LESS W 16.50 FT OF S 158.47 FT-(MAP 13/13N)(OR 3639-2559)
Property Tax ID#: 1301-615-0136-000-7 Lot No.12 W16.5
Site Plan Name: Block No. 173
Project Name: PALOMAR
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
100Lf of 4ft chain link fence. (2)Double gate 6' wide. 12Lf of 6ft chain link fence with (1) single gate 3'
wide
CONSTRUCTION INFORMATION:
Additional work toe nerformed under this permit—check a appy:
HVAC1:1 Gas Tank Gas Piping _Shutters ❑Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers Generator a Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 600.00 Utilities:cn Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name MICHAEL CONRAN Name: MICHAEL CONRAN
Address:1001 S.E MONTEREY RD Company: CONTRACTOR SERVICES OF SOUTH FLORIDA LLC
City: STUART State:FL Address: 1001 SE MONTEREY RD
Zip Code: 34994 Fax: City: STUART State:FL
Phone No.7723613227 Zip Code: 34994 Fax:
E-Mail:SFCONTRACTOR@YAHOO.COM Phone No. 7723613227
Fill in fee simple Title Holder on next page ( if different E-Mail: SFCONTRACTOR@YAHOO.COM
from the Owner listed above) State or County License: CBC1261632
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:
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 fir t inspection. If you intend to obtain financing, consult with lender or an attorney before
commencipgMork,pr recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ,4. L'�(ti,(F, COUNTY OF
The forgoing instrvment was acknowledged before me The forgoing instrument was acknowledged before me
this�day of 2015 by this_L day of J 204�v by
f�r(' p(5,1 (2Oh1y�JN Td&a /9P,Z 6wr:4461
(Name of person acknowledging) (Name of person acknowledging)
---A Z_0�
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificat' Type of Identificat' :1
Produced Produced
;,.:�� KAREN S. NIELSE ''. KAREN
Commission No. :• •_(Sea4},mission k FF 1158 �o mission No. _• mmissio(SWOLSEN
o My Commission Expires ; P°�° My Commi ns# FF 115637
o... June 1 .,�����..`� J s on Expires
-Ili 18
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE VE
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