HomeMy WebLinkAboutHolloway Permit Application 4.16ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ------- Permit Number: ---------
COUNTY ............
•LORIO ...
Building Permit Application
Planning and Development Services
Buildmg and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462·1553 Fax: (772) 462·1578 Commercial ---- Residential�><�--
PERMIT APPLICATION FOR: Fence -#\IC, <>-Cl,h,UY\tn\.JH
PROPOSED IMPROVEMENT LOCATION:
Address: P
Legal Description: (X).)t,{.Cu:ct LlLl£.e., �l{)
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lot No. 2.3
Block No. _
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Back: Right Side:---- Left Side:----
Property Tax ID#: ���
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. " '• ) Project Name: _
Setbacks Front _ I DETAILE� DESCRIPTION� ":,ORK:
rnona wor to
DHVAC
DElectric
� orme un
UGasTank
DPlumbing - .
er t rs permit c ec a
DGasPiping
Osprinklers
appy:
Shutters
OGenerator
D Windows/Doors
ORoof
Total Sq. Ft of Construction: _
Cost of Construction:$ _3s\
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'-"'-'Q.,8�---- Scµ:!; of First Floor:
Utilities: LJ Sewer Oseptic Building Height: _
CONTRACTOR:
State:�
Fax: 321-638-0086
Phone No. 321-636-2829
E·Mail: spacecoast@supenorfenceandrail.com
State or County License: �-
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s_a_s _
Name: Todd Paroline
Company: Superior Fence and Rail
Address: 2778 N Harbor City Blvd #102
City: Melbourne
Zip Code: _3_2_
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3_5 _
State:8_
Fax: -------
Name'--l-!:J!,�}-<-:::r:J�cll',�&!,4,-:-------;;:---
Address: � V
c,ty: Ft£1e.n.e...
Zip Code: 6A:(.f5 \
Phone No. _
E·Mail: _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
OWNER/LESSEE:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAw;ONSTRl18IQIII LIEN LAW INFORMAI,!ON�, - ' " - - - "' 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:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie CountX makes no representation that rs granting a permit will authorize the germ1t holder to bwld the subject structure which is m con ict with any applicable Home Owners Assoclatron rules, bylaws or an covenants that may restrict or prohrbrt 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 re� and posted on the jobsite
before the first inspection. If you intend to obtain financing, con�ith le er yr an attorney before
comerencina work or recording vour Notice of Commencement.
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�1.!:nature of ���r/ Lessee/Agent • S1gn�e or ... 01T ractormcense Holder
STATE OF FL RID\\ . '- STATE OF FLORIDA &: COUNTY OF Luc.t..v COUNTY OF , l,,,l
The forgoing mstrAmen1 was acknowledged before me The forgomg instrument was acknowledged before me
this_ldayof '"\ , 20 �by thisadayof �\\ ,20W__by -s ...... �;,., \\,,\\ow, 1 \0Cl(1 IYl�l,u,\V l
{Name of person acknowledging) (Name of person acknowledging)
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(Signature of Notary Public- State of Florida )
OR Produced ldent1f1cat10� v � . Personally Known Personally Known OR Produced rdentfftcanon
Type of tdentmcatton Produced r-"- n, Type of tdentrtrcanon Produced -
Commission No. , ......... ,,, BE�PHBORER Commission No ,. m��i1.t1IE 15@Bf� .··�>!'!·· •, f.00317933 rr;,.-r �otilry Public · State of lorida . . . c \( J. ,.)!} -·. EXPIRES: Mardi 31. 2m 1� ;Tll <i Comrnm10� # GG 312093 . . ...
··.�0,!,..<1,.·· . o, r,; . ........... Bonded through �3t1on�l :.Otar, Assn . Revised 07/15/2
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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INITIALS
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UAIE - PERMIT SKETCH
REVISIONS
SHEET 1 OF 1
II OAKLAND LAKE ESTATES P.U.D.
LOT 2J - BOUNDARY SURVEY