HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED47
Date: , �S •ate)' �I Permit Number:
cM LSI��llLS
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Commercial Residential
RECEIVED
DEC 21 NZI
St. Lucie County
Permitting
X.
PERMIT APPLICATION FOR: FENCE
PROPOSED IMPROVEMENT LOCATION: 3 '
,1.- i
Address: 1708 OLD FFA RD
Property Tax ID #: 2303-232-0005-000-4 Lot No.
Site Plan Name:
Project Name:
Block No.
DETAILED DESCRIPTION ®aF W®RifC::
PRIVACY FENCE INSIDE PROPERTY LINES 6 ft WOOD STOCKADE, 158 FT LONG ; 1 GATE 3 FT WIDE
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit —check all that apply
_Mechanical _ Gas Tank _ Gas Piping
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Shutters _ Windows/Doors _ Pond
Generator . _ Roof Pitch
Sq. Ft. of First Floor:',
Cost of Construction: $ 1330 Utilities: —Sewer —Septic, Building Height:
WNERAESSEE
I Name
JOHN L. VAN HAREM
Address:
1708 OLD FFA RD
City:
FORT PIERCE State: FL
Zip Code:
34945 Fax:
Phone No.
772-999-4212
E-Mail:
LTVHNSCC@COMCAST.NET
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: SELF
Company:
Address:
City: State:
Zip Code: Fax:
Phone No
E-Mail
State or County,License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, p RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: X Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State:
Zip: Phone:
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lendeflor an attornev before rommenring wnrk nr rPrnrrling vnur NntirP of rnmmPnrpmant
Signa&& of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORID
STATE OF FLORIDA
COUNTY OF �� . ��� C� .
COUNTY OF
Swor o (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization this
Physical Presence or Online Notarization
day of �P , A2151by o2 Qc� J
fi.�)�2),:� I of h 4a. c P n ,
this day of . 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification C 1 ;
Type of Identification
Produe4d
Produced
(Signature of Nota Public- State o flor.Wa_
(Signature of Notary Public- State of Florida )
AUD PY B. UNIPHREY
Commission No. r :�
MY CO-lmSON ik GG 300817
Commission No. (Seal)
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Rev. 5/6/20