HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED JJ��
Date: L5 Permit Number:
s
IBM
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: To Select from dropbox, click arrow at the end of line
Address: 124 SE PRIMA VISTA BLVD
Legal Description: RIVER PARK-UNIT 5 BLK 50 W 35 FT OF LOT 121 AND E 45 FT OF LOT 13
(PARCEL 34/28N) (OR 3692-1058)
Property Tax ID#: 3419-540-0236-000-7 Lot No. 13
Site Plan Name: 124 SE PRIMA VISTA BLVD Block No. 50
Project Name: 124 SE PRIMA VISTA BLVD
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCR)PTION 4F WORK �# ' �"` � `� F
a
INSTALLATION OF 185 LINEAL FOOT OF CHAIN LINK FENCE 4 FEET HIGH WITH ONE GATE
i
.CONSTRUCTION )NFORMr4TION � ..` f sfn
Additional work to be nertormed under this permit—c ec lall appy:
❑HVAC 0Gas Tank as Piping _Shutters E]Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 1,500.00 Utilities:Sewer Septic Building Height:
OWN �t/LESSEE: x , CONT'RACTCR ht�¢
Name Name: UANI
Address:5407 S INDIAN RIVLH UH Company:
City. F State:_ Address
3498 SAINT LUCIE — FL
Zip Code: Fax: City: PO State:
Phone No. Zip Code: 772-446-5329—
- Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: nicomaquln(O-Pho mal .com
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SURPLEMENTAL ST7 Ll
RU E
DESIGNER ENGIN Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: 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 intend to obtain financing, consult with lender or an alto ey before
'T
commencing work or recording-Vour Notice of Commencement.
S
Sign_a_t_u-r_e7o_f_0VP(er/Lesse4/Agent-� Signature of 5W11tracp6Lic&nse Holder
STATE OF FLORI!� '7'�9 STATE OF FLORID4// -,COUNTY OF COUNTY OF
The Ing ins � ent was acknowledged e 7day
t
Pefore me Th ng ins ryRent was acknowledged before me
this fr�clay om-Y_ 20/L5 by this of 2t by
(Name—of 13ers6n' ging) (Name person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification ProducedType of Identification P[pdiiped!�!�_
DAWN
�10ta!`Y Publk,
M"o
Commission No.
Commission No. ti i We Of Florida
Commission-SIIJ Com E
My Comm. Expires Mar 22,2017
Expires A 2-',,.2017 ?
mission#EE 871571
of F� ' " NVion INotary Bonded Through National Notary AssIPRevised 07/15/2014 "
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS