HomeMy WebLinkAboutbuilding permit - fenceAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
440 �CiIG(1(
0
' Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED
Address:
Property Tax ID #:
Site Plan Name:
Project Name:
LOCATION:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
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
Electric —Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 1,000. O D
_ Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: C gxv`oS {ty't-yo\c
Address: M
1 1
Company: t'JYc'jo co^^ Vc'C:Hor' coe(D
City: AE 7i S' LN//F State: �-
Zip Code: ?YJJ'7 Fax:
Phone No. 77 2. .i • 67
Address: 1 OCA S . 33`g 5
City: F� letce. State: ri
Zip Code: 3491147 Fax:
Phone No -7-7d-- q-74
E -Mail: ol.4 E &vd 772nD SM. , LOM.
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail TV40 G tye-'o eoYIP. Coy,.
State or County License coo: 15o9y06
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
if value of NAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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.
Inconsideration 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
withiender,> r an attorney before commencing work or recording your Notice of Commencement.
as Agent
STATE OF FLORIDA
COUNTY OF I VL/I 1
S4ior,n to (or affirmed) and subscribed before me of
thissP yslcal Pr Mine Notarization
dayOfrba 2020 by
Name of person making atement.
Personally Known _V_ OR Produced Identification
Type of Identification
fjy• Y;i Notary PUCK-Sttpptop� Florida
Commission No. + mission 11964670
•..,or ti,•' My Comm. Expires Feb 24, 2024
Bonded throe h National NahryAso,
re
STATE OF FLORIDA
COUNTY OF 5+
Sworn to (or affirmed) and subscribed before me of
Y, Physical Presence gr Online Notarization
this a71day of 5�er��el�\d. , 2020 by
coy l,�_yyr2eo lQ.
Name of person making statement
Personally Known is OR Produced Identification
Type of Identification
Produced
(Signa of FW"/. BRK -AT
MY COMMISSION # GG 176593
Commission No. EXPIRE�S,pg ry 17, 2022
• "Bended iteu Na Publk =rl
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Rev. 5/6/20