HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
Building Permit Application JUL b7 2019
Planning and Development Services permitting Department
Building and Code 23Regulation Division St. Lucie County
00.1/irginia: venuj,F,oLL-iecceia�:3-49&Z.
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 5811 Bamboo Dr
Property Tax ID#: 3402-610-0352-000-8 Lot No. 4
Site Plan Name: INDIAN RIVER ESTATES-UNIT 09- BLK 82 LOT 4 (MAP 34/12S) (OR 3574-1' Block No. 82
Project Name:
DETAILED DESCRIPTION OF WORK:
Installing 112 feet of 6 foot board on board on the side of house j
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: 112 Sq. Ft.of First Floor:
Cost of Construction:$ 1824.00 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameJeremy Theisen Name: Mark Seguin
Address:5811 Bamboo Dr Company: A Quality Fencing, Inc.
City: Fort Pierce State:_ Address: 105 East easy street
Zip Code: 34982 Fax: City: Fort. Pierce, FL State: FL
Phone No. 772-801-1999 Zip Code: 34982 Fax:
E-Mail: Phone No772-252-4907
Fill in fee simple Title Holder on next page(if different E-Mail aqualityfencing@gmail.com
from the Owner listed above) State or County License 26866
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 jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commen ing work or rp-cording your Notice of Commencement.
Signat re of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 2>1�-C,uc, COUNTY OF C{-,Luc; -e,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of C GL� ,20_A by this )L day of ( - 2020_nby
1 i
Name of person making statement. Name of person making statement.
Personally Known V/OR Produced Identification Personally Known � OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-S Y GABRIELLE HICKS Sig ture of Notary Public-Sta ,,�,
:�•°Y�`- C.G ,, N1':Y .; GABRIELLE HICK
C '�q. MY OMMISSION#GG 7 �
Commission No. =*: *Se om ission No. (9 OMMISSION#GG T
'o,. PIRES:February 2,2 2� PlRES:February2, 4
%:;,odltgp•• BOnded ThN Notary PuDIIC
,pf.ft41 Bonded ThN Notary PubflC
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.9/26/18