HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED.FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: I qO W ' 0.3 04
- -- - - - - - 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) 46271578 Commercial Residential X
PERMIT TYPE: Building - Fence
PROPOSED IMPROVEMENT LOCATION:
Address: 3117 Yellowstone Circle, Fort Pierce, Florida 34945
Property Tax ID #: Lot No.116
Site Plan IName: Block No.
Project Name: Ward.
DETAILED DESCRIPTION OF WORK:
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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: $ 12,080.00 Utilities: —Sewer _Septic Building Height:
"OWNER/LESSEE: -
CONTRACTOR: ".
Name Christian Ward
Name: Tashara Lively
Company: Professional Grade Fence
.,Address: 3117 Yellowstone Circle
City: Fort Pierce State: _
Address: 470 Martin Road SE
City: Palm Bay State: FL
Zip Code:*134945 Fax:
Phone No. 954-830-0792
Zip Code. 32909 Fax: 321-312-4787
E-Mail: !
Phone No 321-749-9884
Fill in fee simple Title Holder on next page (if different
E-Mail professionalgradefence@yahoo.com-
from the Owner listed above)
State or County License
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
Name:_
Address:
City:
Zip:
Phone
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 YOUR LEMPER OR ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
ature of Owner Lessee/Contractor as Agent for Owner Sign at of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF nb Motif COUNTY OF Bte)1drd
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this (l day of :lone 20J by this J]— day of OVne* 20A by
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Name of person making statement. Name of person making statement. P
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Personally Known OR Produced Identifi ti6. ° Personally Known X OR Produced Identifica ' ' Z
Type of Identification H a n Type of Identification m o
Produced �,), `yp�S �i it tASs ; 3. _Q Produced 1) o
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(Si ature of Notary Public- State of Florida) o (Signlatdre of Notary Public- State of Florida 5, °' M
Commission No. I 727 (Seal) Commission No. J(e 77 (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.