HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLiCABLE:INFO MUST BE COtVIP,LETED"FIaRAPPLICATION TO;BE ACCEPTED
Elate:.. Permit N.u..mber;. _
_ RECEIVED
Building:, Permit Appli'c#io DEC 162021
P1dnWhq bnd-t?ev lopment$ervices
8urlding=and code RegutatiowDivision ST. Lucie County, Permitting
2300.0rgirda Avenue,Fort Pierce FZ s498z
Phone- 1772}462 1553 Fax:,{?7z}. c21s7s Camrner ia,t Reid rival
PERMIT TYPE FENCE
PROf?QSEO ItVIPRI VEMENTTOCATION::
Address: . 47100.INDRIO RD.-FORT'PIERCE,'FL 34951
Property Tax 16 4:. '1418433-0040-000-7 Lot.No
Site Plan Name: ...... Block No.
Project Name CHAMBERS ..
I"ETAILED bE k(P'TION OF,WORK'
IEIISTALLATIOA OF 444FT OF 5FT BLACK:VINYL CHAIN LINk FENC NG'yy/'(1)12 FT GATE'ND.(2)6FT GATES
CQNSTRUCTIGIN INEORN]AT,
ION
Additional work to be performed 'under ths;permit—check all that apply:, .FENCING
_Mechanical GasTahk Gas,.Piping Shutters windows/Doors
_Electric `Plumbing _Sprinklers —Generators _Roof Pitch:
Total Sq,,Ft of Construction: 444FT .. Sq:;Ft.of Firstfloor:
_.Cost of.Construction:.S 2400.00 Utilities: Sewer Septic Building Height:
�V41NER/LESSEE `CONIRACI`C3R
Name, Rossan No d ranri Chambers - Name_Ross--A..Charnbers
Address. 120Q N FFA'RD Ccimpany:Adron Fence
FORT PIERCE, FL 1182 NE 12th:Sf..
-City: State:- Address: .
Zip Code.:, 34945; Fax: City;.Okeechobee State FL
Phone No. - 800-282-5172 Zip Cade: 349:72 Fax; 863=76„3-84044
E-Mail: pemits@adronfence.com. Phone:No 800-282-51!72 .. .
€ill rn fiee simple Title Holder on next page if different E MV it permits@adconfence Corp
from-the Owner listed aboue); State or County'License 18971
If value of construction is$1500 or mores.a REM11DED Notice of Commencement:is required:
If value—of HVAC is';$7,500 or more;a RECQRDED'.Natice of Commencement is required..
SUPPLEMENTAL CC1N5Ti UCTiC7N 1 �1 LAWIWORMATIQN
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY X Not Applicable
Name,- Name:.
Address: Slat Address clt City e: y State; ..
Zt Phone Zt
p. Phone:
p;.
FEE SIMPLE TITLE HOLDER. IVot Applicable BONDING CC?MPANY: X Nat Applicable
Name: Name::
Address: Address:.
City: - City
Phone: Zip:
Phone:-
OWNER/CONTRACTOR AFFiDViT:Application is herebymade to obtain a petmitto..do the.wark ago installat,ionas indicated.
It ertifythat no'work o .installatlon hascommencecl prior'to the issuance of a.permit:
St.Lucie'Counttyy makes nd.representation that is granting a.permit will authorize the permit holder:to build the subject structure
which js,�n:.conflict with any_applicable Home Owners Association•rules,bylaws or a�d:covenantsthat-may restrict yr prohiblt such
structure.Please consult with your Home,Owners Mtociation and review your deed for any restrictions which_may apply:
Inconsideration of the granting of this requested.permit l do hereby agree that l will, in all:respects,.perform the:work
n'accordance.with the approved plans,the Florlda euildln'fCodesand St.:Wcie County Amendments.
The following building permit applications are exempt from undergoing a fiull co.ncurrency review:room:additions,
accessary structures,;swimming pools,fences,ti+ralls,signs,screen rooms and•accessory uses to an other non-reside ntial use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMEINCEMENT MAY RESULT IN,YOUR PAYING`
TWICE FOR iMPROYEMENT'S 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 FINANCING, CONSULT
WfTH YOUR`LENDER 9111:AN,ATTORNEY'BEFORE.RECORDING YOUR NOTICE OF COMMENCEMENT;''.
Signature of Owner/lessee/Cc ntractor'as Agent'for'. wr er Signature of Contractor/License Hoitler
STATE OF`FLORIDA I`STATE OF FLORIDA
COUNTY'OF:ai acwesa COUNTY OFsoKfmgo13FE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisIL day.of eA+ 2021 by this day of.'l;? s6nAQ k ;2021 by
ROSSA:cHAISERS ROSS$CiiPMBERa^ ;
Name of person making statement; Name of person.makng statement.
o. 4 8;z 4'
Personally Known x OR Produced Identifca V—m m Personally Known x OR Produced,Identificat' rV
b
4 CS O
Type �, =4 Type V w= x
T e of identification, K a T e of identification.
Produced A �. l° : ;'
Produced -. <�'" !!A
n
=a'-'�E
.`*'ems' y ou a o, r: . Q, e
Notary } t.
p. {Signature of Notary Public-State of Nod A} x a W.a
{Signature of Nola. Public-State of.6lorida
L ray o per o
Commission No., (Seal) � ' ,�'o '
Comrnissionluo,° (Seal) ..tag
aN• rah.51*:s
OEVIEWS FRONT ZONING SUPERVISOR' PLANS VEGETATION SEA TURTLE MANGROVE
CO.t1(+l7ER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE -
RECEIVED
DATE'
COMPLETED
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