HomeMy WebLinkAboutSmith Permit Application 5.21ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:-------- Permit Number:--------
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Fence
Commercial _ Residential .i. __
PROPOSED IMPROVEMENT LOCATION: •
Address: '52_ \..f 1� 1<'11 I>\' · \,:,i )O?fl '9, f\(11') P1 J?L\£l5-/-
legal Description: N ru:l mi I I \ ·111 (\(\p ')/ l .J.hp u I\ ' IJ n i .\-- 1\1\ln 'P,I IYII' IL ,�,
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PmpertyTaxlDdi
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IDooq-100-5 lot No.
Site Plan Name:_ _ Block No. ---
Project Name: ' I
Setbacks Front _
lrl'S-ttJJI 141 D!Lw' we -11ence : -= :: .,,. Back: Right Side: left Side: _
CONSTRUCTION INFORMATION: .. , '
D Windows/Doors
DRoof
L Aocrnona! work to Ole :rlormed under tms permit check all Dapply:
OHVAC Gas Tank DGas Piping _ Shutters
DE1ectnc D Plumbing Dsprinklers D Generator
Total Sq. Ft of Construction:--------
Cost of Construction:$ I 0'5 0. 00
OWNER/LESSEE: ..
59,:.£!; of First Floor:
Utilities: LJ Sewer D Septic
CONTRACTOR:
Building Height: _
Name I ,r,,�IY\Hh
Addrels !52).;0ullJ<CL.-k c,ty:\_eosen2ieofh
Zip Code: :Z,LjLj'5]:- Fax: _
Phone No. _
E-Mail.:_----------------
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Todd Parolme
Company: Superior Fence and Rail
Address: 2778 N Harbor City Blvd # 102
City: Melbourne
z,p Code: _3_
2
9_3_5 Fax: 321-638-0086
Phone No. 321-636-2829
E-Mail: spacecoast@superiorfcnceandrail.com
State or County License: 03:_
1
c:_
3
3:_7 _
State:B._
State:�
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SfJmEr'·1li!NTAec61t.;-wucnONi1JEN,LI\W I��:,,, .. '';y; . �� . 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 is granting a permit will authorize the germit holder to build the subject structure which rs in con ict with an'{ applicable Home Owners Association rules, bylaws or an covenants that may restrict or prolubrt such structure. Please consult with your Home Owners Association and review your deed for any restrictmns 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 eddrtrons.
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another ncn-resrdentral 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 th�:i} inspection. If you intend to obtain financing, consul:,ith lender or an attorney before
commenci work or recording vour Notice of Commencement_...
/JI! W(( � /hA- s s, of Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE
OF� �Luo..e) STATE OF FLORIDA &lu.ctV COUNTY COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrumcl,i'a/ lcknowledged before me
this2Q..dayo(::::t:Y\°"1 , 201.D.by th1sW__dayof l ,20?.iJby
J Tu:lcl m YQvti vLe.. " lOrlc!-- VI +>tH::DU n tJc..2 (Name of person acknowledging) ' (Name of person acknowledging)
\'ilP �k'\ O ;�JY[f '� �/,ovf\Anl//1 0 '\)_, __ , � l 7t',. Ii. v 1..,,r
(S�l)1[JJ1" of Notary Pubhc....el.ne of Flor� ) [Srgnatur f o ry Public- State of e7t1a ) v
Personally Known� OR Produced Identification ___ Personally\nown � OR Produced rdennncaucn
Type of Identification reduced Type of tdentmcano Produced
Commission No. • . sm<,r.i.i� Commission N 'i� SIFPHANIE BR&fi@al) '.i�\·. Noltry i'ubllC. State of Flonda Notal)' Public · State of Florida ·:. :. <t*" :J,:. Commm)O(l # GG l1�09l i_�:.i ;j, Comm1mon ; GG 31 zogJ ;:.,;-, ' ·-�.'?.':\�;�11,-i�ih ti�{ional t.otar)' Ann. .. o. f\ "-Y 1..omm. Lxp1re� .. pr ...
Revised 07/15/ · · · · Bi;r1<1ed through Nanonal Notary A11n. 14
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS