HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED \
Date: , a 5 Permit Number; U 1 d a
-RECEIVED
Building Permit Application
Panning and Code
ion Divi s �A J' c U i a
Building and Code Regulation Divtsro,�
2300 Virginia Avenue, Fort Pierce FL 34982 ST, Lucie County, Permitting
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residentia
PERMIT APPLICATION FOR: Fence
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PROPOSED//IMPROVEMENT LOCATION: & 'S 0 / O
Address: Co -3 0� Q11 , `� 'E- VLegal Description: Ck6—,f �5 Wlqy _ ZdT
Property Tax ID#: 3 y 2 ,) 1- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Q n� o V 0 .3 P I/c:,
/tee �vC [y /�, y�� i- y w,� IKg Firs-
CONSTRUCTION INFORMATION:
Additional work to j��e orme under this permit—check all apply:
HVAC tJ Gas Tank I]Gas Piping _Shutters a Windows/Doors
11Electric Plumbing FISprinklers Generator Roof
Total Sq.Ft of Construction: S Ft,of First Floor:
`b a _
Cost of Construction: $ J��• — Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name * . �l S Q —Q r Name. Scott Peters
Address: 6-,3 0) C a't �-ti/440- Company: All Indian River Fence
i City: E f• /moi e T-c--e— State: Address: 790 SW Airoso Blvd.
Zip Code: �_ Fax: City: Port Saint Lucie State:FL
i Phone NoZip Code: 34983 Fax: 772 878-8283
E-Mail: I Phone No. 772 340-1045
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) I 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 i 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: 1
City:
Zip: Phone: f Zip: Phone:
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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 theermit holder to build the subject structure
which is in conflict with any applicable home Owners Association rules,bylaws or andcovenantsthat 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 tine 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
commgncing work or recording our Notice of Commencement.
Signature of Owner/Agent/Lessee Sfgna ure of Contractor/License Holder
STATE OF FLORIDA. (j STATE OF FLORIDkV
COUNTY OF VT- 1i�Q COUNTY Of fJ I
i The forgoing instrume t was acknowledged before me i' The fo oing rostrum t was acknowled ore me
i this day of 211 (,&by 4 this day of 20� I
(Name of person ackn ledging) ; (Name of person ackno dging)
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Igna71v
o ry Public-State of Florida) ( ignatur o to Pt+h tate of Florida)
Personnown c 0& 'f aced ld8AaRit�lFQ. H Personally Known cA ENCH
Type of Identification Pr u'" <'; Notary Public-State o ort a Type of!dent+ficatIOn Pr Q "My Expires Dec 11,2021 My Comm.Ex67258
Commission No. Commission N �
National Notary Asci.
Revised 07/15/2014
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REVIEWS FRONT ZONING 1 SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER f REVIEW T REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS s
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