HomeMy WebLinkAboutPermit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �i
Date: Permit Number:
a,.. ON, ° ° Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential XXX
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:.(772)462-1578
PERMIT APPLICATION FOR:Fence
PROPOSED IMPROVEMENT LOCATION:
Address: 400 Natalie"Dr.Port St Lucie, FL"34952-7901 "
Property Tax ID.#:_3426-664-0001-000/4 Lot No.1
Site Plan Name: La Buona Vita Block No."
Project Name: Williams
DETAILED D€SCRIPTION OF WORK:,
118ft x 4ft High.9 gauge green chain link fence with"bottom tension wire
Two 6ft wide chain link walk gate
New Electrical Meter Second Electrical Meter
..CONSTRUCTION INFORMATION:
Additional work to be performed under this'permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
Electric _Plumbing _Sprinklers _Generator =Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 2,256.00 Utilities: Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Ralph Williams/Thomas-"W Czajak Name:Jay R Cash
Address:400 Natalie DrCompany:Fences By Cash, LLC
City: Port St Lucie State:_ 'Address:,.1772 SE Durango St
Zip Code: 34952 Fax: City::Port St Lucie State:FL
Phone No.(914)213-8639. Zip.Code 334952 Fax:'
E-Mail:tczajak@gmail.com' Phone,No (772)777-2808
Fill in fee simple Title Holder on next page(if different E-Meijfencesbycash@comcast.net
from the'Owner listed above) State or County License 30620
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a 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 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
Signatur f er/ essee/Contractor as Agent for Owner Signaturep o ct r/ icense o der
STA �/TE OF FLORIDA STA /OF FLORIDA
COUNTY OF S�i- 1.,yt�t_ COUNTY OF --�:�"�
Swornn�l --(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
L,-Physical Presence or Online Notarization sical Presence or Online Notarization
this �-day of ,g'42020 by thisjgng�_day of 2020 by
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Name o person making statement. Name of pers n making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification 1�; n
ype of Identificatio
Produc d /X�" roduced(Signature of Notary P lic-State of Florida ) i nature of Notary Publ' State of Florida1111Commission No. (Seal) ommission No: (Seal) N T-
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