HomeMy WebLinkAboutSLC Permit info - Pam FogtALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: June 28, 2018
Permit Number:
Building Permit Application
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 T
PROPOSED IMPROVEMENT LOCATION:
Address: 12746 Refuge Lane, Jensen Beach, FL 34957
Legal Description: EDEN'S REFUGE LOT 6 (OR 381-535)
Property Tax ID #: 4504-702-0007-000-3
Site Plan Name: Fogt Fence Install
Project 'Name: Install Wood Fence
Setbacks Front 24„ Back: 24"
Right Side: 24" Left Side: 25'
Lot No. 6
Block No.
DETAILED DESCRIPTION OF WORK:
Install 25' LF of 4' tall board on board wood fence and 141' LF of 6' tall board on board wood fence.
CONSTRUCTION INFORMATION:
Additional work to be Pertormed under this permit– c�all appy:
HVAC 0 Gas Tank OGas Piping _ Shutters ❑` Windows/Doors
Electric O Plumbing OSprinklers Generator I—! Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 4,490.00
S Ft, of First Floor:
Utilities: Sewer Ilseptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NamePam Fogt
Name: Darrick Bailey
Company: A Great Fence
Address: PO Box 2914
City: Stuart State: FL
Zip Code: 34995 Fax:
Phone No.521-3785
Address: 751 NW Enterprise Drive
City: Fort ST Lucie State: FL
Zip Code.. 34986 Fax: 408-0272
Phone No, 812-0223
E -Mail: pwfagt@yahoo.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: info@agreatfence.com
State or County License: 23954
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name:-
Address:
MORTGAGE COMPANY: Not Applicable
Name:,
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: , Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 }clans, 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, wa[is, 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 ' spection. If you intend to obtain financing, consult with lender or an attorney before
commencing' Flo k or recording your Notice of Commencement.
Signat ,k of gtvnq�/ ssee/C r as Agent for Owner
ST E OF FLOR A
C NTY OF s Lucie
The forgoing instrument was acknowledged before me
this 27 day of June , 20 18 by
Darrick Bailey
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Produce
{Signa otary Pu lc- State 'f Flor' a )
Commission No. o �z, RYSTAjLeY)BISHOP
= Y C(3MMISSION # GG127618
*� EXPIRES July 24, 2021
REVIEWS IFRONT ZONING
COUNTER REVIEW
11
of
ST Lucie
The forgoing instrument was acknowledged before me
this 27 day of June .. _ _____e 20 18 by
Darrick Bailey
Name of person making statement
Personally Known x OR Produced Identification
Type of Identific'�
Produced
(Signature of Notary Public- State
ission GGt278i8 (Seal}
�•'"w�- �RI�tSTA Y BISHOP
''� MY Cr7n7l�,u erntir «.-.
SUPERVISOR iPLANS
REVIEW REVIEW
QETATION 1 SEA
REVIEW
DATE
RECEIVED
..DATE ---- --- - —
COM PLETED
Rev. 8/2/17
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