HomeMy WebLinkAboutSLC Permit Application - Island ClubAll APPLICABLE INFO MUST BE
Date: October 8, 2020
S51r. War,
O
Planning and Development Services
Building and Code Regulation Divisic
2300 Virginia Avenue, Fort Pierce FL
Phone: (772) 462-1553 Fax: (772
LETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
1578
Commercial X Residential
PERMIT APPLICATION FOR: Fence
PROPOSED IMPROVEMEN LOCATION:
Address: 10410 S Ocean Drive, Jensen Beach, FL 34957
Property Tax ID #: 4511-514-0000-0 0-9
Site Plan Name. Island Club Fence ristall
Project Name: Install PVC Fence
DETAILED DESCRIPTION OF
NOT FOOL BARRIER, install 78' L.l
New Electrical Meter
ORK:
6' tall PVC Shadow Box fence.
nd Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed
_Mechanical _ Gas Tank
— Electric — Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 4,180.00
OWNER/LESSEE:
NameHutchinson Island Club HOA
Address:10410 S Ocean Drive
City. Jensen Beach
Zip Code: 34957 Fax:_
Phone No. 772-332-8157
E-Mai I: kasig@advpropmgt.com
Fill in fee simple Title Holder on ne
from the Owner listed above)
ler this permit — check all that apply:
Lot No. 1 & 2
Block No.
Gas Piping Shutters Windows/Doors Pond
_ Sprinklers _ Generator hoof
Pitch
Sq. Ft. of First Floor:
Utilities: `Sewer _Septic Building Height:
CONTRACTOR:
Name: Darrick Bailey
Company:A Great Fence
State: _ Address:751 NW Enterprise Drive
City: Port ST Lucie
State: FL
Zip Code: 34986 Fax: 772-408-0272
Phone N0772-812-0223
page ( if different E-Mail info@agreatfence.com
State or County License CGC1527571
If value of construction is 2500 or more, RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a REC RDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION
DESIGNER/ENGINEER:
Name:
Address:
City:
jJ(
Zip: Phone
LIEN LAW INFORMATION:
Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
Address:
State: City:
State:
Zip.* Phone:
Not Applicable BONDING COMPANY: Not Applicable
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Name:
City:
Address:
Zip: Phone:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVI
I certify that no work or installation has
: Application is hereby made to obtain a permit to do the work and installation as indicated.
commenced
prior to the issuance of a permit.
St. Lucie County makes no representation
which is in conflict with any applicable Plome
that is granting a permit will authorize the permit holder to build the subject structure
Owners Association rules, bylaws
structure. Please consult with your Horr
or and covenants that may restrict or prohibit such
e Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested
in accordance with the approved plans,
permit, I do hereby agree that I will, in all respects, perform the work
the Florida Building Codes and St. Lucie County Amendments.
The following building permit applicatio
accessory structures, swimming pools, fences,
is are exempt from undergoing a full concurrency review: room additions,
walls, signs, screen rooms and accessory
WARNING TO OWNER: Your failure
improvements
uses to another non-residential use
to Record a Notice of Commencement may result in twice for
to your property.
Lucie Cou, y and posted on the
paying
A Notice of Commencement must be recorded in the public records of St.
jobsite before the first inspection. If
with len a
9r or an ttorne Wore
u intend to obtain financing, consult
commencingwork or recordin r otce of Commencement.
5ignatur of owner !� ssee/Contracto
as Agent -for owner
5ignat of Corrttractor/ ices a Holder
STA OF FLORIDA
CO NTY OF sT Lucie
STA OF FLORIDA
COUNTY OF ST Lucie
Sworn to (or affirmed) and subscribed
x Physical Presence
efore me of
Sworn to (or affirmed) and subscribed before me of
or Onlin1020
this 8 day of October
Notarization
by
x Ph sical Presence or
y Online Notarization
this 8 day of October 2020 by
Darrick Bailey
Darrick Bailey
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced
Type of Identification
Identification
Personal! Known X
y OR Produced Identification
Produced
Type of Identification
Produced
O STAL Y BISHOP
1
Signature of Notary u tare
(Signature of Notary blic-
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SS10N # GG1276
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July 7k, 2021
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EXPIREJuly�24, 2024
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