HomeMy WebLinkAboutPermit PackageAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: June 23, 2020
...a
77
COUNTY
PERMIT TYPE: Fence
PROPOSED IMPROVEMENT LOCATION:
Permit Number:
Building Permit Application
Commercial Residential X
Address: 5009 Paleo Pines Cir, Fort Pierce, FL 34951
Property Tax lD #: 1312-801-0141-000-0 Lot No.337 & 338
Site Plan Name:
Project Name: Cichocki, Tom
DETAILED DESCRIPTION OF WORK:
Install - 5' green chain link fence 1 - 5' wide and 1 - 10' wide gate
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Mechanical
Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ ? ��
Gas Piping
Sprinklers
Block No.
_ Shutters _ Windows/Doors
_ Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Tom Cichocki
Name: Geary S. Adams Jr.
Company: Adams Fence 2 LLC
Address:5009 Paleo Pines Cir.
City: Ft. Pierce State: R
Address;1206 8th St
City: Vero Beach State: FL
Zip Code: 34951 Fax:
Phone No. 772-203-8957
Zip Code: 32962 Fax.
E-Mail: tomandgina54� @gmail.com
Phone No 772-999-2038
Fill in fee simple Title Holder on next page ( if different
E-Mail elizabeth@adamsfencecompany.com
State or County License 27078
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC 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 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 FINANCINC, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
ignature of owner Lessee/Contractor as Agent for Owner
--••—
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY Oli Gil.) el
COUNTY OF Indian River
The forgoing instrumWt was acknowledged before me
The forgoing instrument was acknowledged before me
thisZ3�bay of J 20 Z.C,b-v
this 23rd day of June 2020 by
I,r
Geary S. Adams, Jr.
tement.
Name of pers& ma:70R
Name of person making statement.
Personally Known Produced Identification
Personally Known V. OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
lip
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Adams Fence2, LLC
1206 8th St
Vero Beach, FL 32962-1401
+1 7729992038
info@adamsfencecompany.com
ADDRESS
Tom Cichocki
5009 Paleo Pines Cir
Ft. Pierce, FL 34951
772-203-8957
ACTIVffY
Services
Install - 215- 5' Green Vinyl Chain Link Fencing
w/Bottom Tension Wire
1 - 10' Wide Double Drive Gates
1 - 5' Wide Gates
All posts concreted
Services
Permit & NOC
ESTIMATE # 7741
DATE 06/16/2020
OTC RATE AMOUNT
3,675.00
125.00
-------------------------------------------------------------------------------------------------------------------- ..........................................
Material, Labor, and Taxes are all included in price. TOTAL $3,800.00
Do it yourself is only for material.
Please sign, date and return this estimate with a copy of your survey &
a 50% deposit upon acceptance.
'surveys are not needed for repairs"
This price reflects a 3% discount for cash or check transactions. The
3% discount does NOT apply for credit card transactions.
Adams Fence is not responsible for any damage to sprinklers.
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