HomeMy WebLinkAboutPermit App - JoRockyAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/15/2021
Permit Number: 2105-0404
LLL
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
,Address:
Property Tax ID #1: 142-802-0001-0001 Lot No.
Site Plan Name:
Block No.
Project Name: Install chainlink fence
DETAILED DESCRIPTION OF WORK:
Not pool barrier - install 125' LF of 5' tall black vinyl chainlink fence west 2 5' walk
gates at north and west side, 160' LF of 6' tall black vinyl chain link north side, and 10'
double gate west side.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit — check all that apply:
_Mechanical
Electric
_ Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
OWNER/LESSEE:
Name
Gas Piping
Sprinklers
_ Shutters
Generator
Sq. Ft. of First Floor:
Windows/Doors Pond
— Roof Pitch
Utilities: —Sewer —Septic
Address:12800 SW 128th St
city: Miami State: EL
Zip Code: 33186 Fax:
Phone No. 3 5-220-3506 E-
mail: 'orock 93 gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Name:
Company: Great Fenn. LLC
Address: 751 NW Enterprmse pr SUitLQS_
City: Port St Lucie State: EL
Zip Code: -34986 Fax: Z7- _
Phone No
E-Mail
State or County License CGC 1527571
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNI
Name: _
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name: _
Address:
City:
Zip:
Phone:
x Not Applicable
State
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name: _
Address:
City:
Zip:
Phone -
_ Not Applicable
State:
Not Applicable
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 OWNE :Your failure to Record a Notice of Commencement may result in paying twice for
improvements t your property. A Notice of Commencement must be recorded in the public records of St. Lucie County a d p sted on he jobsite before the first inspect�ionou
you intendto obtain financing, consult
with lender orttora l fore commencin work or recordr Notice of Commencement.
Signature of OVUner/
as Agent for Owner
STATE OF FLORIDA
COUNTY OF St Lucie
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this day of 20G1 by
Name of person makings ement.
Personally Known OR Produced Identification
�Ypf of Identification P/?duced
(Signatu,r4o7—Notary Pubiic- State of
Commission No.(;6 q29,54Kj
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
4 N Notary Public State of Florida
Crystal E Naylon
+� My Commission GG 929549
�!a Expires 11106/2023
SUPERVISOR PLAT
REVIEW REVIE
7VEGETATION
SEA TURTLE
REVIEW
MANGROVE
REVIEW