HomeMy WebLinkAboutPermit ApplicationAII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION
Date:
TO BE ACCEPTED
Permit Number:
Plonning ond Developnent Sewices
Buildinq ondcode Requlation Division \
2j00 Virginio Avenue, Fon Pierce FL j4982
Phone: (772) 462-1ss3 Fax: 17721 462-1s7a
Building Permit Application
Residential
PERMIT TYPEI
PROPOSED IMPROVEMEI{T LOCATION:
P.operty Tax lD #:
Site Plan Name:
Lot No.
Block No.lQL
Prore(r Name. ilo, un
DETAILED DESCRIPTION OF WOR(:
CoNSTRUCTION INFoRMATIONT
Additional workto be performed underthis
Mechanical
permit-check all
_ Gas Piping
spnnklers
that applyr
_Shutters _Windows/Doors_ Gas Tank
_ Electric Plumbing _Generator
-Roo,
-Pitch
Total sq. Ft of construction:Sq. Ft.of First Floorl
costofConstruction:$ 9.111,5 "' utilities: sewer -septic
Building Heightl
lfvalue ofconstruction is S25oO or more, a RECoRDED Notice ofcommencem€nt is required.
lfvalue of HVAC h S7,5oo or more, a REGoRDED Notice ofcommencement is required
OWNER/LESSEE:CONTRACTOR:
Name
City:
zip code:3!951-
Phone No. ?71. q6l Sltll
E Mail:
Fill in fee simple Title Holder on next page ( iI d:fre.ent
from the owner listed above)
State:U_
NameiTashara Lively
Company , Professional Grade Fence
Address 4T0 l\,llartin Road SE
City:Palm Bay state:IL
zip Code:!!!P Faxt 1321)3 12 4187
Phone No (321)749-9884
E-Mail professionalgradefence@yahoo.com
State or County License 30485
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
OESIGNER/ENGINEER: Not Applicable
Na me:
Address:
City:State:
Zipi Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City:Statel
Zipi Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Na me:
Address:
City:
zip:Phone:
BONDING COMPANY: _Not Applicable
Na me:
Address:
City:
Zap: _
OWNER/ CONfRACTOR AFFIDVIT: appli.ation is hereby made to obtain a permit to do thewolk and installation as indiGted.
lcertifyihat no work orinitallarion hascommenced priortothe issuanceof a permit.
5t. L-cie Co-ntv mahet no reorelentation that 's prantin! a oe/mir wrll authon2e the oermrt ho der !o burld (he sub,ect stru(tu.e
wh ch is ncolfict with anr dool(able Home Owiers As;ociaron rules. ovlawsorand (ovena.rsthat mav restnct dr oroh, oit suc h
5t.u(t-re Please consult w th your Hore Ow4e.s Associarron and r€vrew your deed for dny rennd ons {thrcl m.y apply.
ln consideration ofthe Branting of this requested permit, I do hereby aSre€ that lwill, in all respects, perform the work
in accordantewith the approved plans, the Florida BuildinE Codes and St. Lucie Cou nty Amen dm ents.
Thefo lowing building permit appllcatiors are exemptfrom undertoing a fuilconcurrency revi€w: room additions,
accessory structures,5w mmirg pools, fe.ces, waLls, signs, screen rooms ind accessory usesto another non-re!identialuse
"WARIIIXG TO OVII{ER: YOUR FAILURE TO RfCORD A iIOTICE OF COMIiIEI{CEIIIEI{T iIAY RESULT IIT YOUR PAYI G
TWICE FOR IUPROVE Ef,TS TO YOUR PROPERTY. A ITOTICE OF COiIiIEIICEiIEIIT iIUST AE RECOROED AIID
POSTED OT{ T]IE JOB SITE BETORE TflE FIRiT II{SPECTIOII. IF YOU IYTEXD IO OBTAIX FII{AiCII{G, COI{SULT
WIIII YOUR LE DER OR A ATTORiEY BEFORE RECORDI G YOUR XOTICE OT
ractor as aSent for owne.
STATE OF TLORIOA
COUNTY OF .1 /;zi€
TheforEoinE instrument was acknowledged befo
thislLdayof l]1lrzh .20& by
Nameof pe60n makint statement.
Persona ly Known _ OR Produced lde
Tvoe of ldent fr.atlon
eroaucea Fl ltti,tt* )itensc
{sicnatureof Publjc'state of Florida )
commission No. !/alf2l . (sear)
6.396a-9
STATE OF FI-ORIDA
rhe IorEoinE instrument was acInowledted be
th,s lLdayof nlr/h .20212 b
Name of person mak nE statement.
Personally Known X oR Produced rd€nti
Tvo. of ldentifi.atron
P;oduced /v/A
of Notary Public- stite of
connissionno..!2lf)l
SUPERVISOR
REVIEW
VEGETATION
REVIEW
FRONT
COUNTER
ZONING
REVIEW
OATE
COMPLETED
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.fOSEPH E. SM]TH,
FILE * 4687236
CLERK OF TTiE
OR I}oOK 4395
CIRCUIT COURT - SAINT LUCIE COUNTY
PAGE 1858, Recorded O3/73/2O2O 09:17:38 AM
NOTICE OF COMMENCEMENT
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