HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO((MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED y
Date: y\�ro`��b Permit Number: \4b
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Building Permit Application APR 162318
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division /
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Fence
PROPOSED IMPROVEMENT LOCATION:
Address: i D d M 7 d U r �' 3
Legal Description: INDIAN RIVER ESTATES-UNIT-04-BLK 34 THAT PART LOT
19 LYG N OFFOL DESC LI: BEG NE COR LOT 18 THNLY 10
FT TH SWLY TO NW COR OF LOT 18 AND END OF SPEC
DESC LI(AIAI'34/020 (OR 3 17-15 12 : 872-1108 : 1121-
Property Tax ID#: 375) 3 L10 a— G 6 O a Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION-
Additional work to be e orme under this permit—check a appy:
HVAC n Gas Tank ❑Gas Piping C
Shutters Windows/Doors
11Electric ❑ Plumbing Sprinklers Generator ❑ Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ SJ n Utilities: _Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name.T e_ -) `A/6 Name: Scott Peters
Address 0 J U _ Company: All Indian River Fence
City: tee- State:�_ Address: 790 SW Airoso Blvd.
Zip Code�,�V !Z Fax: City: Port Saint Lucie State:FL
i
Phone No2,_9- 9) 93— / 1 3 2- Zip Code: 34983 Fax: 772 878-8283
E-Mail: Phone No. 772 340-1045
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) 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 MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: i Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: I Address:
City: City:
Zip: Phone: Zip: Phone: i
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 thepermit 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 Nome 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 t 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.
Sign ture of Owner/Agent/Lessee Signature of Contractor/License Holder i
STATE OF FLORI A I STATE OF FLORIDA J
COUNTY OF. COUNTY OF S+
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The forgoing instr ment was acknowledged before me The forgoing Instrument was acknowledged before me
this day of Q YYrpU/ 2n IZ by this ( .5 day of N c�r/ .201a by
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(Name of person acknowledging} (Name of person acknowledging)
(Signature of Notary Publ;c-State of Florida) (Signature ary Public-State of Florida) f
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Personally Known OR Produced Identification ersonally Known ----�OR Produced Identification
Type of Identification Produced "� A— pe of Identification Produced
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"Public,State of Florid
Commission No. W� mmission No.
f� d �ROBERTS
--- missicn#FF 170158 Notary utrlic-State of Florida
Af comm.expires Oct.20,201 -
'.'�• :•= Cornmission P FF 221708
my Uomm.ExpiresTray 10,2019
Revised 07/15/2014 P rvdthrought;^tlonalNotary/ .sn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
i COUNTER f REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
1 DATE
I COMPLETE
k INITIALS 1