HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J ` �7�
Date: Permit Number: / 'U Q l/ —o 457.
Building Permit Application MAR 142o18
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
PROPOSED-II'MPR,OVEMENT LOCATION -T u
Address: 5005 Fort Pierce BLVD, Fort Pierce FL
Legal Description: LAKEWOOD PARK-UNIT 3-BLK 18 LOT16 (MAP 13/14N)(OR 3824-1963)
Property Tax ID#: 1301-603-0046-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION ONF WORK
Wooden 6' fence in back yard
CONSTRUCTION INFORMAT_ ION. . "
Additional work tobe a orme " under this permit—check P a apply:
HVAC 11 Gas Tank []Gas Piping _Shutters ❑Windows/Doors
1 Electric 0 Plumbing Sprinklers 1i Generator FIRoof Roof pitch
Total Sq. Ft of Construction: 1336 SFt. of First Floor: 1336
Cost of Construction:$ 1500 Utilities:In Sewer E]Septic Building Height:
OWNER/LESSEE r, CONTRACTOR "
Name JBM Import Corp Name: Roderick Waller
Address:PO Box 86 Company: Sunrise City CHDO.Inc.
City: Paramus State:NJ Address: 3550 Okeechobee Rd
Zip Code: 07653 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: rodwallerl@gmail.com
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY:r _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 first inspection. If you intend to obtain financing, consult with.lender or an attorney before
commencing work or recording our Notice of Commencement.
V.
Signature of Owner/ ssee/Contractor as Agen or O r�e:�� Q�' ignature of Contra or/License Holder rN
STATE OF FLORIDA TATE OF FLOR
COUNTY OF y �r COUNTY OF my�g
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W�W� ¢O NEC.2
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The forgoing instrume t was acknowledged-before m Sim The forgoing instrument was acknowledged befor X-1
this day of � 2_ by ` w this day of YY?t�R1!* .26Zby_
Ev2i a�ller 0 b �d2i
(Name of person acknowledging) ;•,;;t (Name of person acknowledging)
(Signature of N ryublic-State of Florida (Signature o otary Pu )/lic-State of Florida)
Personally Known OR Produced Identification Personally Knowny OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE_
COMPLETED
ev.