HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4571. r 7'J-) Permit Number:
RECEIVED
Mr FEB 17 2021
�W
V a o Building Permit Application Permitting Department
St. Lucie County
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Installing Vinyl Fencing
PROPOSEDA.MPROVE MENT LOCATI, N:
Address: 5407 Palm Drive
Property Tax ID #: 3402-609-0122-000/3 Lot No. 24
Site Plan Name: Residence - David T & Susan Tillman Block No. 55
Project Name: Install New Fence
DETAILED DESCRIPTION-OF'WORK::'
Remove Existing 4' tall galvanized fence damaged in Hurricane Matthew
Install 140 Feet of New 6' Tall Vinyl Fence with 2 Gates (1 - 8' wide - South side)) (1 - 7' wide - North Side)
New Electrical Meter Second Electrical Meter
GONSTRUCTI`ON"I'NFORIVIATION. "''
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: 840 Sq. Ft. of First Floor: 2266
Cost of Construction: $ $2,475.00 Utilities: —Sewer —Septic Building Height: 15'
OWNER/LESSEE:.. .. _
CONTRACTOR:
Name David T & Susan Tillman
Name:
Address: 5407 Palm Drive
Company:
City: Ft Pierce, FL State: F L
Zip Code: 34982 Fax:
Phone No. 772-465-7643 (cell -772-528-7675)
Address:
City: State:
Zip Code: Fax:
Phone No
E-Mail
E-Mail: davidtid@bellsouth.net
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License
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.
SUP.-PLEMENTAL CONSTRUCTION LIEN LAW]NFORMATIO,
.. :u . , a
_
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.
S gnature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S Air i 1 i a G i e
COUNTY OF
Swo to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Ph1sical Pres ce or Online Notarization
Physical Presence or Online Notarization
this day of t?)0 , 292trby
this day of 2020 by
� y i)> ) )L--n-7 RN
Name of person making statement.
Name of person making statement.
Personally Known / OR Produced Identification
Personally Known OR Produced Identification
Type of Identific�tio- ,
Type of Identification
Produced IIJA it L.
Produced
� /1J
(Signature of Nota li -State of Florida
(Signature of Notary Public- State of Florida )
Commission No. AUDR[�� a¢jUMPHREY
,, Y COMMlISSIO # GG
Commission No. (Seal)
360817
EXPIRES. March 6, 2023
vu Notary P1
I lic Underwriters
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