HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 1' oS o • (5 Permit Number: 154 1'Q 1 GC1
„E UU1V_D SEP 8 2015 SCABN1N�
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Building Permit Application St. Lucie County
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 YES Residential
PERMIT APPLICATION FOR: Fence
PROPOSED IMPROVEMENT LOCATION:
Address:, 7 152�''i''•i lRSl I
Legal Description:..r35 40 S9-1 Fi 4' n aae' of E Q94' L>�' ncI/mil
CJF ccc '/4 IeIIscC dol' _,R LAS-I Cor 3r�3-tc;zqi
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Property Tax ID M A`- 54 - S1 k - Oc-03 - o0o - S Lot No.
Site Plan Name: Block No.
1
Project Name: ��C7i 1 CTe� L5
Setbacks Front 1ois'S" Back: O Right Side: Q Left Side:
DETAILED DESCRIPTION OF WORK: P94`"
CONSTRUCTION INFORMATION:
itiona wor to e e orme under tispermit-c ec a appy.
11HVAC Gas Tank ❑Gas Piping Shutters ❑ Windows/Doors
_Sprinklers
11 Electric OPlumbing ❑ Generator EDRoof
Total Sq. Ft of Construction: So. Ft. of First Floor:
UO
Cost of Construction: $ I _ Utilities: D Sewer El Septic Building Height:
OWNER/LESSEE: - =- _-- _- _
CONTRACTOR:-
Name pc 3 a
Name: 1 iE✓
Address:�-+� O^I �2 c�
Company: 1�i\iC�S �C e _ Oe)i(-P-
City: \_ C lI fir+ State: FL
Address:aa<3(�S
City: tic_xo`�� Stater
Zip Code: i�l�-( Fax:1`lad`d3 a5<
Phone --rip s3. 3 23
Zip Code: `�'-�� 7 Fax:-I� ' ag3 •a
E-Mail:lfY _A4-5 Uh @ ICG • am
Phone -1-1a a3'�J
Fill in fee simple Title Holder on next page (if different
E-Mail: (\/L-t
State or County License: 0(2-
from the Owner listed above)
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If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 ermit 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult -with- lender or an attorney before
commencing work or recording your Notice of Commencemanti-�
47
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_ Signatu a of Owner essee/ ent
Si ature of o tract /License Holder
STATE OF FLORIDA
Lne
STATE OF FLORIDA
VY�A
COUNTY OF t L.,.
COUNTY OF
The forgoing instrument was acknowledged before me
The for oing instrument was acknowledged before me
a�
this day of 20 to by
this day of 9 20 E by
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s JL n'd LQ'_7 xb-),(Z.
(Name of person acknowledging)
(Name of person acknowledging )
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ignatu e f
ignature of Notary lic- State of rida )
Persona y1C¢o &u@MN&Mific ion -
-state
Personally Known _ OR Produced Identification
Type of Identification Produced
_
Type of a ti 'p Ie of Florida
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°•' Sep 19,2018
� ;° Commission # FF 1
Commi£ iop NJAg.
Commissio Npi•"'.'8°", ON C. R&wtvrlro�'
`A: .��5 Notary Public - State.ot Florida
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Revised 07/15/2014
- 70 ... ....
•' ?«� �d •'• Commission i# FF 15118`
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ZONING
SUPERVISOR
PLANS
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DATE
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COMPLETE
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