HomeMy WebLinkAboutPermit ApllicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
'COUNT
IF L o
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: Fence
PROPOSED IMPROVEMENT LOCATION:
Permit Number:
Building Permit Application
Commercial Residential X
Address: 4876 CHRISTENSEN RD, Fort Pierce, FL 34981
Property Tax ID #: 3403-502-0148-200-8
Site Plan Name: WHITE CITY
Project Name:
Lot No.85
Block No.
DETAILED DESCRIPTION OF WORK: I
Installing 67' of 4' black chainlink fence with two 5' gates
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing
Total Sq. Ft of Construction: 67
Cost of Construction. $ 11500.00
Sprinklers _ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Heather 3(4ay) -Mar son
Name: Mark Seguin
Address:4876 CHRISTENSEN RD
Company: A Quality Fencing, Inc.
Address: 105 East easy street
City: Fort Pierce State: a
Zip Code: 34981 Fax:
City: Fort. Pierce, FL State: FL
Phone No. 772-579-1419
Zip Code: 34982 Fax:
E-Mail:
Phone No772-252-4907
Fill in fee simple Title Holder on next page ( if different
E-Mail aqualityfencing@gmail.com
from the Owner listed above)
State or County License 26866
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:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
Zip: Phone:
City:
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 b recorded and posted on the jobsite
before the f��{st inspection. If you intend to obtain financing, consul ith lender or an attorney before
commencidelwork ter record�g your Notice of Commencements /] A
Lessee/Contractor as Agent for Owner
STATE OF FLORIDA�
COUNTY OF O
The forgoing instrument was acknowledged before me
thisO'FSday of A"f& , 20P1 by
Name of person ma
kingant.
Personally Known Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No. 1iUm ZABRILked# HICKS
11
�'�Notary Public -State of Florida
r......r.len i..w A LIN 7091%1) ll
Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this Chi day of AP2- , 2001 by
(6wori g_%(,r_ l4ic e-S
Name of person making statement.
Personally Known✓ OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
(a 1-1 795o;p,
Commission No. A
GAB MLE HICKS-
;�;p' r '' Notary Public -State of Florida
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