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POD's name:
Plan examiner's name:
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• Copy of survey/drawing'
• NOC
• Declaration of covenant /0(12�-
Date:J al—t-7-5,VL-X
(please print clearly)
(please print clearly)
Please call our office with any questions 772-999-2038 or email to elizabeth@adamsfencecompany.com
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-2553 Fax: (772) 462-1578 Commercial Residential X
PERMITTYPE: Fence
PROPOSED IMPROVEMENT LOCATION:
Address: 4805 Eagle Dr
Property Tax ID #: 1312-801-0045-000-7 Lot No. 242
Site Plan Name: Block No.
Project Name: Bennett
DETAILED DESCRIPTION OF WORK:
Install 5 0 4 high pvc fence
1) T wide double drive pate
1) 4' wide gate
NSTR ICTiON INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical — Gas Tank ® Gas Piping ® Shutters _ Windows/Doors
Electric — Plumbing _ Sprinklers — Generator — Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 2,879.00
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic Building Weight:
OWNER/LESSEE:
CONTRACTOR:
Name Nancy Bennett
Name: Geary S. Adams Jr.
Address:4805 Eagle Dr
Company: Adams Fence 2 LLC
Address:1206 8th St
City: Ft. Pierce state: FI
Zip Code: 34951 Fax:
City: Vero Beach State: FL
Phone No. 7
zip Code: 32962 Fax:
Phone No 772-999-2038
E-Mail:
Fill in fee simple Title Bolder on next page ( if different
E-Mail elizabethO-adamsfencecomnanv.com
from the Owner listed above)
State or County License 2707
B value of construction is $2500 or more, a RECORDED Notice or Lommencemem is requireu.
ff value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
I
DESiGNERIENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
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 Biome 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 J SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/FdKtfracitr as Agent for Owner
FLORIDASTATE OF
COUNTYOF
The forgoing instrument was acknowledged before me
this _ day of April , 2021 by
Lcq t, S aa^M
Name of person making statement.
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
of
IWY Laffi4l
rr S APO 1,20.
2D1Qil�G SUPERVISOR
COUNTER REVIEW REVIEW
Geary S Adams !_
Signature of ra r/License Holder
STATE OF FLORIDA
COUNTY OF Indian River
The forgoing instrument was acknowledged before me
this � _ day of April , 2021 by
S "A-'
Name of person making statement.
Personally Known Z OR Produced Identification
Type of Identification
Produced
(Signature of Not akv taubl. - SfitB�
MANDY L. vv t
iREs: April 1. 2023
PLANS
REVIEW 1 REVIEW REVIEW REVIEW
MANGROVE