HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1 • u C
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (7,72) 462-1553 Fax: (772) 462-1578
Building Permit Application
Commercial Residential X
PERM IT.TYPE;.guilding --Fence
PROPOSED IMPROVEMENT LOCATION:
L,,a-.-. 5M1 Killarnev Ave. Fort Pierce. F16rida'.34951
Property Tax ID #:
Site Plan Name:
Project Name: Kristoffersen
DETAILED DESCRIPTION OF WORK:
T Sj,aIl I(gCi of 4fi 4n11 ChMlink -rghce, Qh qft i.UIL{P go -ids v
Lot No.18 & 19
Block No. 158
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all thatzpply:-`
_Mechanical _ Gas Tank _ Gas Piping _ Shutters' _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq; Ft of Construction: Sq. F.t..of. First Floor:
Cost of Construction: $ sslw 00 Utilities: Sewer Septic Building Height:
OW N E RAESSEE:
CONTRACTOR:
Name Brit.Kristoffersen
Name:'Tashara Lively
Address: 5501 Killarney Ave .
Company: Professional Grade Fence'
City: Fort Pierce State: fJ,
Address: 470 Martin Road SE
Zip Code: 34951 Fax: Nia
City: Palm Bay State: FL
Phone No. (954)673-9863
Zip Code: 32909 Fax: (321)312-4787
E-Mail: N/A
Phone No (321)749-9884
E-Mail professionalgradefence@yahoo.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License 30485
If value of construction is $2500 or more,,a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, 5 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 restriction's 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,
accessorystructures, 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Sig ture of Contractor/L' ense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF &wde
COUNTY OF B—d
The forgoing instrument was acknowledged be
The forgoing instrument was acknowledged bef g
this 16 day of september 201 b
this 16 day of September 201q by
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O r�
Brit Kristoffersen k
Tashara LivelyLL co
Name of person making statement. N
Name of person making statement.
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Personally Known OR Produced Identi cafioriN
Personally Known X OR Produced Identif' argon a
Type of Identification a o E �
Type of Identification
Produced FL Drivers License z; o
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Produced N/A 0 0
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(Signature of Notary Public- State of Florida) 'S
(Signature of �! taryP c- State of Florida)~ r.sb ,
Commission No. 161727 (Seal)
Commission No. 161727 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19