HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: O�^
---x`;71 RECEIVED
•
Building Permit Applicati n MAR 0 5 2019
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 X
PERMIT TYPE:Building / Fence Installation
PROPOSED IMPROVEMENT LOCATION:
Address: 202 Jeffrey Lane, Fort Pierce, Florida 34982
Property Tax ID#: 2434-803-0006-000-6 Lot No.6
Site Plan Name: Block No.
Project Name: Dalsgaard
DETAILED DESCRIPTION OF WORK:
Install 441ft of 6ft tall wood fence; Install 162ft of 4ft tall chain link fence. GluAnC r�
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 8850 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Pamela Dalsgaard Name:Tashara Lively
Address:202 Jeffrey Lane Company:Professional Grade Fence
City: Fort Pierce State:_ Address:470 Martin Rd SE
Zip Code: 34982 Fax: City: Palm Bay State:FL
Phone No.954-294-1504 Zip Code: 32909 Fax: 321-312-4787
E-Mail: Phone N0321-749-9884
Fill in fee simple Title Holder on next page(if different E-Mail professionalgradefence@yahoo.com
from the Owner listed above) State or County License3dy$5
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH OUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
1)�,/ ,, a,�5� d- :265_t-an
ignature of Owner/-Cessee/Contraci4,as Agent for Owner S gnature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Jueie COUNTY OF AXjVAjd
i
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this I day of JbAreh 20 14 by this I day of Yjjdfek 20 19 by
Payneki DkAaAid -Ta5heve -V I
Name of person making tement. nN2
Name of person making statement.
Personally Known OR Produced IdentificatiPersonally Known OR Produced Identificat nc o�
Type of Identifica ionType of Identification v o 0
Produced F� �iVllS lASC Produced 1? b o.E N
ATEUZN�w
(Signature o otafy Public-State of Florida ) (Signature of tary Public-State of Florida ) In Commission No. &1-7l-7 (Seal) Commission No. 41-727 (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
,Rev.2/7/19