HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:--,. ��� • g Permit Number:
Building Permit Application JU:CE
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Planning and Development ServicesBuilding and Code Regulation Division ST. LuciY,
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial _ Residential xxxxxx
PERMIT APPLICATION FOR: Fence
PROPOSED IMPROVEMENT LOCATION: /�
Address: c�`l S'r'SOt-7 (_�Gt� )1774, �ia--C� Fz_
Legal Description. HOLIDAY PINES S/D-PHASE I-LOT 101 (MAP 13/12S)(OR 3529-795;3552-327)
Property Tax ID#: 1312-500-0102-000-1 Lot No.101
Site Plan Name: Block No. na
Project Name: fence replacement
Setbacks Front Back: 15 Right Side: 7.5 LeftSide: 1 '2-5-
DETAILED DESCRIPTION'OF WORK:
replace fence on left and right sides of property and add fence from east comer of lot to right
(southeast) side of rear patio, and add fence from east comer of driveway to garage (as noted on
enclosed survey plan) 4,A,9 �WCP_oA:�//MWdA) A-41y
CONSTRUCTION INFORMATION:
Additional work to be nartormed under tispermit—checka appy:
HVAC Gas Tank E]Gas PipingOGenerator
Shutters I]Windows/Doors
Electric 0 Plumbing Sprinklers Roof Roof pitch
Total Sq.Ft of Construction: na S . Ft.of First Floor: na
Cost of Construction:$ $2,200 Utilities: Sewer Septic Building Height: na
OWNER/LESSEE: CONTRACTOR:
NameSteven R.Vigliano Name: (homeowner)
Address:5311 Suson Lane Company:
City: Ft. Pierce State:FL Address:
Zip Code: 34951 Fax: City: State:
Phone No.772.577.6663 Zip Code: Fax:
E-Mail:vigliano@att.net Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
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:Steven R.Vgliano Name:(homeowner)
Address: Address: 5311 Suson Lane
City: FL Pierce 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. I intend to obtain financing,consult with lender or an attorney before
commencing work or recafflirA your Notice of Commencement.
S nat ee tractor as ge or Owner Signature of Contractor/License Holder
STATE OF COUNTY OF ORtDA J�' 1 C' 1 r COUNTY OF STATE OF FLORIDA
The for oing instry ment was acknowledg before me The forgoing instrument was acknowledged before me
this day of 20 by this day of 20_ by
e� V i 9L-I' Ek WO
Name of person makirostatement ✓ Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced 1. L. Produced
l
CJS
(Signatu of Notary P (Signature of Notary Public-State of Florida)
vis'.
RtN S. NIELSEN
Commission No. ? State A��FIq,rida-Notary Public
Combrii�Sbn #GG 207484 Commission No. (Seal)
F o°� My Commission Expires
June 12, 2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17