HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONe
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �
Date: 9130/19 SCANNED Permit Number: , v (�" ")f
By
t�,, .l yr - St. Lucie County
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Building Permit Application '�ec�6�9 1b
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 PEA
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT TYPE: Fence
PROPOSED IMPROVEMENT LOCATION:
Address: 3660 W. Midway Rd. Fort Pierce, FL 34981
Property Tax ID #: 3403-502-0156-100-6 Lot No.
Site Plan Name: Liberty Baptist Church Fence Block No.
Project Name: Liberty Baptist Church Fence
DETAILED DESCRIPTION OF WORK:
Remove 381' of 6' old wood fence. Replace Wth new 381' of 6' black vinyl chain link fence.
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
Electric _ Plumbing
Total Sq. Ft of Construction: 381'
Cost of Construction: $ 12,447.00
_Sprinklers _Generator
Sq. Ft. of First Floor:
-Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Liberty Baptist Church Inc.
Name: Ross A. Chamners
Address:3660 W. Midway Rd.
Company*Adron Fence
City: Fort Pierce State: FL
Zip Code: 34981 Fax:
Phone No.-
Address:1132 NE 12th St.
City: Okeechobee State: FL
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 julie.adronfence@aol.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.
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f -
SUPPLEMENTAL CONSTRUCTION LIEN,LAW INFORMATION:
DESIGNER/ENGINEER: __V, Not Applicable
Name:
MORTGAGE COMPANY: _A Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: _C 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 any applicable Home Owners Assoc 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-JUENDEq tik AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMEFMMENT."
Sign ture of Owner ess a/Contractor as Agent for owner
Signature of Contra or/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ow-hobee
COUNTY OF Okeechobee
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this sore day of September 20Jg by
this aom day of september 2011 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
Produced
c-,y�t�k�.;of Florida �l1LIESNELL
(Sign re of NoIGG19P581771�;
(Signatu of Notary Public- a e,
��'•' �fi? Nota Public -State of Florida
�• •: Notary
Co�S@lf
g�.x °"�'•• JULIE SNELL
j,�;`: N`ta_ ryptrhlic-State of Florida
Commission No. e: pGG19587%
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Commission No. • a sslon 4 GG 195877
•..,,, ,�i�,,,:� mm. pues Mar 13,2022
" Bonded through National Notary Assn.I
'•..,f,r i�r My Comm. Expires Mar 13, 2022
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19