HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLET D FOR APPLICATIONTO BE ACCEPTED
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Date: Iola-7117 BY Permit Number: F -/
St. Lucie County
Building Permit Application JUL _5 2017
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 %C Residential
PERMIT APPLICATION FOR: Fence
PROPOSED IMPROVEMENT LOCATION:
Address: 784 SE Prima Vista Blvd, Port St. Lucie , Fla. 34952
Legal Description: River Park, Unit 3-Blk 28, Lot 1 (Map 34/22S) (o 3024-1208)
Property Tax ID #: 3419-515-0190-000-4
Site Plan Name: Sam Real Estate Holdings
Project Name: Mendoza
Setbacks Front 145 Back: 0 Right Side: 0 Left Side: n/a
Lot No.1
Block No. 28
DETAILED DESCRIPTION OF WORK: III
Install 114' of 4' Commercial Grade Chain Link Fence at Rear Property line and left SW comer of
propety
CONSTRUCTION INFORMATION:
i iona worKtOpenerformed under
tispermit—check
all apply:
11HVAC Gas Tank
❑Gas Piping
In
❑Windows/Doors
0 Electric 0 Plumbing
Sprinklers
_Shutters
ElGenerator
D Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ 1915
Utilitiesn. Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Sams Real Estate Holdings LLC
Name: Ross A. Chambers
Address:144 South Sewalls Point Rd
Company: Adron Fence Co
City: Stuart State: FL
Zip Code: 34996 Fax:
Phone No. 772-219-2787
Address: 1132 NE 12th St
City: Okeechobee State: FI
Zip Code: 34972 Fax: 863-763-8404
Phone No. 800-282-5172
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: adronfence@live.com
State or County License: 18971
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
ESIGNER/ENGINEER: _ Not Applicable
N e:
RTGAGE COMPANY: _ Not Applicable
Na
Addr
Address.
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE LDER: _ Not Applicable
Name:
BONDING COMPA _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 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 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 inten�-tt�obtain financing, consult with lender or an attorney before
commencine work or recordine vour Notice of Commencement. /
as Agent for Owner
STATE OF FLORIDA
COUNTY OF OKEECHOBEE
The forgoing instrument was acknowledged before me
this I,l day of _qli 20 L7—by
STATE OF FLORIDA
COUNTY OF OKEECHOBI
The forgoing instrument was acknowledged before me
this 27 day of DUNE . 20 17 by
ROSS A CHAMBERS ROSS A. CHAMBERS
(Name of person acknowledging) (Name of person acknowledging)
Aqu�d
(Signature of Notary Public- State of Florida )
gww
(Signature of Notary Public -State of Florida )
Personally Known X
OR Produced Identification
Personally Known x
OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission No. 9
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