HomeMy WebLinkAboutBuilding Permit Application ti
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/1/2015 Permit Number: � )�• 0
_00- RECEIVEr,
Building Permit Application
Planning and Development Services DEC 1 2015
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
PRO.ROSED IMPROVEMENT LOCATION
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Address: 3307 Avenue J, Fort Pierce, FL 34946
Legal Description: PLAT 3-SUNLAND GARDENS BLK 43 W 1/2 OF LOT 4 AND ALL LOT 5(0.28 AC)
(OR 867-2674: 1412-1583: 1526-2757 ;2041-2947 :2075-633 :2095-2212)
Property Tax ID#: 2405-701-0103-000-3 Lot No.4&5
Site Plan Name: Block No. 43
Project Name: Wiley
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
4' Chain Link Fence Install in Front yard
CONSTRUCTIO7 .1777N INFORM77
ATION
Additionalwork toe performed under tispermit—c ec a appy:
HVAC Ei Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 2160 S Ft.of First Floor: 2160
Cost of Construction:$ 800.00 Utilities:Sewer[]Septic Building Height. 91
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OWNER/LESSEE, n CONTRACTOR
Name Robert J Wiley Name: Roderick Waller
Address:3307 Avenue J Company: Sunrise City CHDO, Inc.
City: Fort Pierce State:FL Address: 800 Virginia Ave Suite 61
Zip Code: 34947 Fax: City: Fort Pierce State:FL
Phone No. 2 0 1• 42 52S-1 ' Zip Code: 34982 Fax: 772-907-0420
E-Mail: Phone No. 772-201-2850
Fill in fee simple Title Holder on next page(if different E-Mail: rodwallerl@gmaii.com
from the Owner listed above) State or County License: CGC1515114
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CQNSTRUCTION LIEN LAW INFORMATION ,.. }
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DESIGNER/ENGINEER: _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 thepermit 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
commenc-ing work or recording our Notice of Commencement.
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_Signature of Owner/L ee/Agent Signature of Contractor/Licens Holder
STATE OF FLORI n_ _ STATE OF FLORIDV
COUNTY OF COUNTY OF.
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The forgoing 's ryo�
The forgoing instrument was acknowledged beg g instrument was acknowledged before
this day of� �pn 20/.� this A day of J�L[_ 20 �J'by
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(Name of person acknowledging) *� (Name of person acknowledging)
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(Signature of N t ry Public--State of Flori a) (Signature of N ry Public-State of Florida)
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Personally Known � v OR Produced Identification Personally Known OR Produced Identificati
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS