HomeMy WebLinkAbout Building Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8-17-21 Permit Number: 11 Q3S
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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
PERMITTYPE: Fence
1 RatlirlWAIT LOCA11ON:
Address: 5495 McDonnell Dr
Pro pe rty Tax ilk# _n 1 614 018 00.0=4--.. _ Lot No. 9
Site Plan Name: Block No.
Project Name: Kellie Block
POWMON€ F WORK:
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: Sq.Ft.of First Floor:
Cost of Construction: - z! ' b'Utilities: _Sewer _Septic Building Height:
: la; CONTRACTOR:
Name Kellie Block Name: Steve Adams
Address:5425 McDonnell Dr Company:Adams Fence C'o Ca, any I I Q
City: Ft. Pierce State:R Address:1206 8th Street
Zip Code: 34951 Fax: City: Vero Beach States
Phone No. 404-597-1233 Zip Code: 32962 Fax:
E-Mail: Phone No 772-999-2038
Fill in fee simple Title Holder on next page(If different E-Mail info@adamsfenciIlg,co�mpay com
from the Owner listed above) State or County Ucense
if value of construction is$2500 or more,a RECORDED Notice of Commencement Is required.
It value of RVAC Is$7,500 or more,a RECORDED Notice of Commencement Is required.
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DESIGNER ENGINEER:' Ptot A licaO.h, Nc>�App[tcali[e
AP NI{�FiTGAGE Ct�IiPANY.
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Ad3a-ess: Address:
City State' Crty....:.
ate ;
2Ip E?hne Zt I?Ftclte .
E S[ri .l fI�LIE OLD &. Ntata 4 p[ ble �0NDING OMPANY ____Nofi A p t able
Name, ..
_ Name:.,,
Addr6 :
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Ztp,. Phone: Zija.. Photae
Qk4iNER,CONMAMOR AFFIDW-,Ap'plkatlan:is hereby niadeta s bta+n a persrEatta do, work and instaiiatlort as ind'tcat d
tcertifyt[aatrtowork.ar-Instal4tion has commedced.prior to the Issuance ota perWL
St-Lucie Coun roakes no representation that is granting apeirnit will authorize the ermlt Bolder to build the stabjet"tstructure
�utticfi is•in confiYctrrtth anX-appiicabiFlame C1uSfnrS(SSSttiation rute5,byrlaw�orticpirenants tlrarna 'restricto�°3�iiGSh
structure.PP4se cartsult w h yopr Home°th"ners Assoclatiomand revieveyour dee f-fvi arr{restrictiattsvu#ii"sh:rrtaV
ln:co,nwd_6faton oftho fanting of this"t®quest s peCzrfst;I do.hereby agree that l.vrtl,,iO ait respects;per#orm the uvor :
inaccardance?ayi€htheappro+ted�tans, he. Qrttla�ttticttragCodesend5t tuneCouqt�Rmenjflt;
The:#otiaivirt building.permit:lapplications•are> xornpt from undergoing a:full cancurrency rEvtevr rrsrtrat additions,
'acc.�ssoiy.structtss,swianming pouts,fences,suits,>signsrsca`�Eri;rooms and actessffry tisses to.az�v�ier nab-esrd���(ttsa .. ;. •. _
'"WARN MC TQ.O ;YOUR,FA LURE` %RECORD,A NOTICE'Of, CO*j.MENd M>_NT MAY t ULT]N YOUR PAYING
7YMiE F0R.d ROYEMENTs-To YOUR p'RoY my. A NOTICE OF tomitF�MT MUST BE RECOI�f1£D AMA
PDSTE>D;,QI THE,JQE SITE BtFdffit li "IRST INSPE;CMN- IF YOU MOOD TO,OBTAW,F HANCIN .CONSUt:T
WITH YOUR CENDE€1,01t AN:As1Tt1i♦EIItEY`.SBFEIRE:1RECd?42i3IAiG YOUR NOTl[Xt`,O Ctilatt WCElHENT:,
Steve Adams-- Steve Adaips
VgnatureT cf.cwnerl less e(Contract .asAgerrt fqr Qiv aer Ssgnaturedf :n sa 'tjUcertse Holder
STIATE[> f6;C76tt17A, STATE OF FLOR10
C 7ltNTY'Cl> 4rt iiata Piuec COUNTY OF irtdian River '
The forgolol?Ihstrument'waS acknowledged before m2 The fo airig,Ynstturnjent was 4&riow7edged before_nae
this ' _1_d�Vef.:August 2021 by: 2021 .hy
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Name of,person-mal ingstatement:. Narne of person makli t statement
Persoraatiy Knqwn OR Pr identification Person:d1IydGnown,,_ __QR Produced.identrfie ttoia
Type•;f'adentrfitgkmi Type of lddntifrcatidn
Pro iuced Pseduced
0.
(Signature of $$ {SignaturQ ?iil} 13ltoritia
Corramission td -." • State of FC iz
comni, I -N : 'F o. State of FljSe
orida"
,. #H 3 , rX NH16800
` a ExnireS 23 S`�CE a9,�
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RECEIVED
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