HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. November lik 2015 Permit Number: 1510 6 a6 a
a also RECEIVLD NOV 12 1015
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,IMP,ROVEMENT LOCATION
Address: 12035 South Indian River Drive, Jensen Beach, FL 34957
Legal Description: TOP OF WALTON S/D LOTS 30 AND 31 WITH RIP RTS(OR 3794-2153)
Property Tax ID#: 4504-601-0030-000-3 Lot No.30 &31
Site Plan Name: Efron Fence Install Block No.
Project Name: Install Wood Fence
Setbacks Front50+' Back: 2"-4" Right Side: 2"-4" Left Side: 2"-41'
DETAILED DESCRIPTION;OF WORK
Remove eighty five feet of existing wood fence. Install one hundred eighty three feet of six foot tall
board on board wood fence.
CONSTRUCTIQN;INFORMATION,-
Additional work to b e nertormea under this permit—check all t=appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
0 Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 2,410.00 Utilities:cn Sewer R Septic Building Height:
OUVNER/LESSEE CONTRACTOR:
Name Efron Investments LLC (Jason Efron) Name: Darrick Bailey
Address:4516 Danson Way Company: A Great Fence
City: Delray Beach State:FL Address: 515 NW Enterprise drive
Zip Code: 33445 Fax: City: Port ST Lucie State:FL
Phone No.561-271-5055 Zip Code: 34986 Fax: 408-0272
E-Mail: Phone No. 812-0223
Fill in fee simple Title Holder on next page(if different E-Mail: info@agreatfence.com
from the Owner listed above) State or County License: 23954
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: x 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: x 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 firs ' spection. If ou intend to obtain financing, consult with lender ora attorney before
commencin rk or recor n your Notice of Commencement.
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—Sig tur oYRIl
r/L e Agent Signat�eWlractor/Lior
older
ST TE OF FA STATE OFORIDA
COUNTY OF STLUC1B COUNTY OF STLude
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this J Q day of A_/0 Vav SL _ 20/.T-by this 'Oh day of N—mber ___,20 /_5-by
Darrick Bailey 1 Darrick Bailey
(Name of person acknowled ' g) (Name of person acknowle ging)
(Signature of Notary ublic- to of Florida (Signature`qffi- � rState lorida)
Personally Know ��abRr,Prod d Identification Person nvvn ••.°S6%°. oduced Identification
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