HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO 7MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Z 12 LIl Z L' 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: 5158 Arm ina PL - Fort Pierce, FL- 34951
Property Tax ID #: 1311-700-0161-000-3 Lot No. 17
Site Plan Name: Block No. 3
Project Name: Dickson
DETAILED DESCRIPTION OF WORK:
Installation of 164FT of 6FT whit
PVC
C!
I CONSTRUCTION INFORMATION: I
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: 164FT
Cost of Construction: $ 7495.00
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: -Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: Ross A. Chambers
Address: 5158 Arming PL
Company:Adron Fence
city: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No. - 800-282-5172
Address: 1132 NE 12th St.
City: Okeechobee State: FL
Zip Code: 34972 Fax: 863-763-8404
Phone No800-282-5172
E-Mail: - permits@adronfence.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Permits@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 Applicable
Name:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY: X Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
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 aapplicable 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 FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF OKEECHOBEE
COUNTY OF oKEEcHoeeE
The forgoing instrument was acknowledged before me
The forgoing instr Um�eprit acknowledged before me
thls _ day of 20� by
�w�as
this � day of __VJ%,J W _, 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
ced .
_ 4iin LAURINDAM WRNS
NotaryPublic Slateof
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lorida Notary Public -State of FICommission
•Commission ! HH 098071
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, 2025y Comm. Expires Feb 25. 2
(Signature of Notary Public-Stat f Florlhr ed through National Nota
ture c otary Pu li
Commission No. IFOq'807I (Seal)
Commission No. (Seal)
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DATE
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Rev.2/7/19