HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONL
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:'J,a0\11 Permit Number: 1a3- O'1d i
SCANNEBECEIVED MAR� 0 2017 .,,, __
BY
St. Lucie R0 iing Permit Applicatio(riY*
Planning and Development Services
Building and Code Regulation Division /'_,motCO C�
2300 Virginia Avenue, Fort Pierce FL 34982 /l.. (_ O �
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Fence
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: k\ S c -e- AT'TGc h tom/
Property Tax ID#: o 0 0 0 - 0 00 - 3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:
Right Side: Left Side:
I DETAILED DESCRIPTION OF WORK: III
:Tnsri.L 11 on L.cTT P.oIor,ty lirc al' o� y'H;9{ womb s/xldiowl3ok
Thep co^F nVf- ,n wit-h 65' of G' Yijh woos( SA4dou go.,r /'c"cc
vc cnvl u.cu Y11Y=1 un]�IC11111L—LIICLRan apply:
�H%J _Gas Tank ❑Gas Piping _Shutters []Windows/Doors
11Electric OPlumbing ❑Sprinkfers []Generator []Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 41/sc?0 ,00 Utilities: Sewer F-1 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
-/J Ci
Name: Scott Peters
Address: DO L M i&y- 0 r '
Company: All Indian River Fence
City:5-eN % (--I? . State: E
Zip Code:!Y qS-�7 Fax:
Phone No. - - -
Address: 790 SW Airoso Blvd.
City: Port Saint Lucie State: FL
Zip Code:-34983 Fax: 772 878-8283
Phone No. 772 340-1045
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
State or County License: #26030
,1 V. Ua YI cunsirucciun is acauu or more, a KecuKutu Notice of Commencement is required.
l
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:
Address:
BONDING COMPANY: _Not Applicable
Name:
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 Coun4 makes no representation that is granting a permit ill authorize permit hoide to build the subject structure
which Is in antlict with anv applicable Home Owners Association rues, bylaws capr and covenants t�iat may restrict or prohibit such
structure. Pease 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 1 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 wncurrency review: room additions,
accessory structures, swimming pacts, 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
A
Signature of Owner/ Agent/ Lessee Signature of Contractor/License Holder
STATE OF FLORIDA�,,j, STATE OF FLORIDA I
COUNTY OF �T (1 t h L if —COUNTY OF
The forgoing instrument was acknowledged before me
_ thisdayof 11104AJL • 20/--Lby
Known
Type of
Commission No. ; rE M cno Expires Dec 1. 2017
g YCd'mr�i Sin # FF 069924
... Bonded Through National Notary Assn
Revised 07/15/2014
The fa joing Instrument was knowledged before me
eX this _,2011 by
0 r 4 / LI PLr.S
(Name of person acknowledging i
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