HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT TYPE: FENCE
PROPOSED IMPROVEMENT LOCATION:
Address: 5110 PALEO PINES CIR FORT PIERCE, FL34951
Property Tax ID #: 1312-801-0096-000-9
Site Plan Name: Serca 5110 Fence
Project Name: Serca 5110 Fence
DETAILED DESCRIPTION OF WORK:
Lot No. 293
Block No.
Install one straight line of 90' total of 6' white PVC tongue and groove privacy fencing to property. No gates.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping — Shutters — Windows/Doors
Electric — Plumbing __ Sprinklers
Total Sq. Ft of Construction: 90,
Cost of Construction: S 2335.00
Generator Roof Pitch
Sq. Ft. of First Floor: 90,
Utilities: — Sewer _ Septic Building Height: 6'
OWNER/LESSEE:
CONTRACTOR:.
Name Anthony J Serca JR)
Name: Ross A. Chambers
Address: PMB #74 PO Box 341008
Com an Adron Fence
City: Bethesda ---State: V4b
Zip Code: 20827 _ Fax: —
Phone No. -
Address: 1132 NE 12th St.
City: Okeechobee State: FL
Zip Code: 34972 Fax: 863-763-8404 _
Phone No800-282-5172
_
E-Mail: -
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail julie@adronfence.com
State or County License 18971 —
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: X Not App
Name:
Address:_
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: _ Phone:
MORTGAGE COMPANY:
Name:
Address: _
City:
Zip: Phone:
X Not Applicable
BONDING COMPANY: X 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 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 BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCINGP CONSULT
WITH YOUR LENDEIJ OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENC MENT."
9
9
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Ho der
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF OKEECHOBEE
COUNTY OF OKEECHOBEE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 15th day of June 2021 _ by
this 15th day of June 2021_ by
ROSS A. CHAMBERS
ROSS A. CHAMBERS
Name of person making statement.
Name of person making statement.
Personally Known _x —OR Produced Identification
Personally Known x —OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
jt�iivl'a•., JULIESNELL
Notary Public - State of Florida
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Rev. 2/7/19