HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr.-
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1r7-t -�T Permit Number:
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l3W d1ftW'FMit 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 x
RECEIVED
OCT 0 5 2018
ST, Lucia Count, D.-
Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: 63440 That part of S 300 ft of SW 1/4 of NE 1/4 and SE 1/4 of NE 1/4 LYG between
US 1 and Turnpike authority FIS/W (or 3764-2758)
Property Tax ID #: 1406-133-0002-000-2 Lot No.
Site Plan Name: Cypress Mobile Home Park LLC Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
I DETAILED DESCRIPTION OF WORK: III
Install 4' high chain link fence with (1) 6' wide walk gate around the pond
I CONSTRUCTION INFORMATION: III
Gas Tank Gas Piping UShutters Windows/Doors
0 PlumbingSprinklers I 1 Generator EIRoof = Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 6,825.00
S Ft. of First Floor:
UtilitiestSewerE]Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ypress Mobile Home Park
Name: Ueary Steven Adams Jr.
Address- Highway 1 F
Company: Adams Fence
Ft. Pierce
City: State: _
Zip Code: 34946 Fax:
Phone No. onnie 79
Address: 1206 am St
City: Vero deach State:FIL
_
Zip Code: 32962 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION
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 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
commencingwork or recordingour Notice of Commencement.
Rev.8/2117
LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State: _
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Signature caner% Lesse Contractor Agent for Owner
Signature o C ractor ense Holder
STATE OF FLO�RID.A�, n
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STATE OF FLORIDA p
=1-e'IG� rGn
COUNTY OF �Y YLiCn
COUNTY OF6-t�r
The f r��Wg instru en was ack�owledg efore me
this��dayof er 20�by
The fo g instrument was acknowledge before me
this ��dayof bz� 20j� by
G� r
cam, �o� s-
y � �� .
N me of person making statement
Name of pe on aking statement
r�OR
Personally Known OR Produced Identification _
Personally Known Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public -State of Florida)
(Signature of Notary Public- State of Florida )
Commission Sal
Commissi
ELI2ABETH EVANS
�'�"" @'•. ELIZABETH EVANS
Notary Public- State of Florida
Notary P°blic-state of Florida
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