HomeMy WebLinkAboutHendricks Permit Application 9.11ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:-------- Permit Number:---------
Building Permit Application
Planning and Development Services
Building and Code Regulatwn Division
2300 V1rgimo Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ---- Residential y
PERMIT APPLICATION FOR: Fence
'PROPOSED IMPROyEMtNT I OCATION:
1:= j
Lot No. .;l;:J
Block No.-�\-
- Back: Right Side: Left Side: _ Setbacks Front. _
Propertv Tex ID#: a1\'D- 1Q'5:=()()1"5,Q-CQO- B
Site Plan Name: __ _,U""l1f1.D"n+-+le
= .... rd.uvkel
tl'-'' Ko..;,_ _
Project Name: ''---'-'---------------------------
1�C�O�NiS�TRiU�C�T�IO�Nit�Nfi�O�R�MiAr��O�N�:'lls;;-""";,r,::=a�,����---'-·�••'"�-��· -���.....lll -Additio"nal w�to bl j,,;;;med unae, th,s pe,mit checr',1, F\ apply: - L
OHVAC Gas Tank OGas Piping L-::::l Shutters O Windows/Doors D Electric D Plumbing Dsprinklers D Generator D Roof
Total Sq. Ft of Construction:--------
Cost of ConstructtonS WO \ s� of First Floor:
Utilities: LJ Sewer D Septic Building Height: _
OWNER LESSEE: " � CONTRACTOR:
Name I .o\ Y\ � YYly ,I Y"<:"" ( \\
Add,�s,_\_Q;�� Jl".MCV
Oty JJQA State EL
Zip Code: �- _ Fax: _
Phone No .. _
E-Mail: _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Todd Paroline
Company: Superior Fence and Rail
Address: 2778 N Harbor City Blvd #102
City: Melbourne State:£!:__
Zip Code: 32935 Fax: 321-638-0086 -------
Phone No. 321-636-2829
E-Mail: spacecoast@superiorfenceandrail com
State or County license: 02"9-"5-"89'------------
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Nat 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:
I certify that no work or installation has commenced prior to the issuance of a permit.
St Lucie Countx makes no representation that IS granting a permit will authorize the germit holder to build the subject structure which ,sin con rct with any applicable Home Owners Association rules, bylaws or an covenants thal 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 grantmg of this requested permit, I do hereby agree that I will, mall respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following buildmg permit applications are exempt from undergomg a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs. screen rooms and accessory uses to another non-resrdenttat use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvement���r property. A Notice of Commencement must b�ir��f� and posted on the jobsite
before the first in c;�t If you intend to obtain financing, co�t wit n r or an attorney before
commenr.HW:> w or r ordine. vour Notice of Commencemenj
'j/ lj ;' /f/7'1/ s
_ S1gn-atufc of Owner/ L�sce/Agent S1gnatuliJ,!' of Contractor/License Holder
STATE OF FLORIDA UWOC-1 STATE OF FLORIDA (l LU.l,\f; COUNTY OF COUNTY OF
The f�omg instrI,ent was acknowledg�efore me The forgoing instrument was acknowledged before me
this jQ_ day of b {ltf!Ylll<\. 20 g by this day of .ptfintx.A . 20 by
:::ladckro $.YD\1111< :::t() ro 00 � JJfi ,LW I
(Name of person acknowledgmg) (Name of person acknowldging)
�
I) Jni,1 /;j In ,0 )� v ,, ' \,, / � fl O 0(1,., t, '" ,D ::- lM 0 ,
(Si�.,.irE1of Notary Pub1i�e of Florei) (Sign �-H�'01fo1ary Public- Sta' f � Florida
Personally Known fu OR produced ide�ficatmn Personally Known� OR Produced Identification __
Type of Idennflcatto Produced Type of tdcnnftcan n Produced
Commission N : ... n�?--it.slE ·Mleft� Commission �, STEPHANIE aRct:R";:"'I
!ff.·� TJ' r-owy ?�n,ic. Sme of flonda 1i'W\ Notary �bllt. �talt °: fLor\<!a -��. �.:.l (orr.mM,on:.C,C,lllO'B
·,., cwf\-�:; 11, ,.omrr. t�., ,. \ff�_;,,.: My comm. b?lm Apr � 1011
Revised 07/ , ,,..n, ,PO!'�ec :r.,�1.11� �atlonal sonry i.1�n. · · .!?' "'6c,ndK thrQIJlh ti.ational Noury Msn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS