HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA LE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �P lS6 -6al�
ie wls Permit Number:
w.
Building Permit 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 Residential x
PERMIT APPLICATION FOR: Fence
PROPOSED IMPROVEMENT LOCATION:
Address: 118 Queen Elizabeth Ct, Ft. Pierce, Fla.
Legal Description: Queens Cove-Unit 1, Blk 8,Lot C as shown on plat marked not included(Or 2065-1110)3065=1475 3071-2323)
Property Tax ID#: 1414-701-0066-000-6 Lot No.C
Site Plan Name: Block No. 8
Project Name: Marmer
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install 86' of 6 PVC Privacy fence on the right & left front corner of house and on the left side then
35' of Black Vinyl Chain Link on left side back to rear of property
CONSTRUCTION INFORMATION:
Additional work to be nertormed under tispermit—check all appy:
❑HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
❑Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 4132 Utilities:Cn Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name: Ross A.Chambers
Address: (i 9 (9bt2eMA CXOIALt)_ (2, Company: Adron Fence Co
City: FKFt/ U-/ I-'State:�� Address: 1132 NE 12th St
Zip Code: 3 4q(�c, Fax: City: Okeechobee State:FI
Phone No. 9T 6 gogo(, 'Z-1-31 Zip Code: 34972 Fax: 863-763-8404
E-Mail: Phone No. 00-282-5172
Fill in fee simple Title Holder on next page(if different E-Mail: adronfence@live.com
from the Owner listed above) 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:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Nra Name: N/A
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: N/A Name: NSA
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 intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
s
-Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF OKEECHOBEE COUNTY OF OKEECHOBEE
The forggqing instr,uTent was acknowledged before me The forgoing instrument was acknowledged before me
tir_,Za clay of 20 LS--by this 2ND day of uUNE ,20 /S" by
ROSS A.CHAME�RS ROSS A.CHAMBERS
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (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 Identif'ca io Pr d c
"„"""�. DOnEEN ELARDI
Commission No. ,SPRY°�s''% (�Se1�"EEiJ ELARDI Commission.N Ion"AY P°e�:'•. Notacy
blic State of Florida _ 4 Public �tt� Florida
•= My Comm.Expires Oct 21,2018 My Comm.Expires Oct 21,2018
w "o`: 50067
om fission ' °`` Bonded Through National Notary Assn.
Revised 07/15/201
Bonded Through National Notary Assn.
REVIEWS FRONT. ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS