HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLEry INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J
Date: ,O�'co� •�� Permit Number:
771 �«
•
Building Permit Application RECEIVE®
Planning and Development Services DEC 2 2 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
,PROPOSED,IMPROVEMENT LOCATION:
Address: 18604 Mach One Dr, Port St. Lucie, Fla. 34987
Legal Description: Aero Acres Blk 1, Lot 5(2.67 ac)or 3769-1030)
Property Tax ID#: 3215-801-0012-000-5 Lot No.5
Site Plan Name: Aero Acres Block No. 1
Project Name: Flack
Setbacks Front 170' Back: 130' Right Side: 54' Left Side: 13'0
DETAILED DESCRIPTION"OF,WORK;
Install 299' of 4' Black Vinyl Chain Link Fence at rear of property around the screened pool.
CONSTRUCTION INFORMATION:
itiona work to be nertormed
. under this permit—check a app y:
HVAC t_I Gas Tank ❑Gas Piping _Shutters I]Windows/Doors
nElectric 0 Plumbing Sprinklers Generator Roof rilitColl
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 2488 Utilities:11 Sewer E]Septic Building Height:
OWNER/LESSEE CONTRACTOR':
Name Flack,Lisa Name: Ross A.Chambers
Address:186004 Mach One dr Company: Adron Fence co
City: Port St. Lucie State:Fl Address: 1132 NE 12th St
Zip Code: 34987 Fax: City: Okeechobee State:FI
Phone No.954-931-8334 Zip Code: 34972 Fax: 863-763-8404
E-Mail: Phone No. 800-282-5172
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
1f value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
12/23/2015 08:28 FAX ,) i�j 002/002
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DESIGNER/ENGINEER: _Not Applicable MORT SAGE COMPANY: Not Applicable
Name: n/a Name: n1e
Address: Addre s:
City: State: City: State:
Zip: Phone' Zip: Phone:
FEE SIMPLE TITLE HOLDER; _Not Applicable BONDI 1YG COMPANY: _Not Applicable
Name: nis Name
Address: Address: e
City: City:
Zip:'Phone: Zip' Phone'
I certify that no work or installation has commenced priorto the issuance o a permit.
St. Lucie County makes no representation that is granting a p rmit will auth irize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Associn ion rules,hyla s or and covenants that may restrict or prohibit such
structure_Please consult with your Home Owners Associatio and review yc ur deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree hat I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St, L ie County Amendments.
The following building permit applications are exempt from u dergoing a fu concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,scieen rooms ani accessory uses to another non-residential use a
WARNING TO OWNER:Your failure to Record a Noti a of Cornmel icement may result in your paying twice for
improvements to your property.A Notice of Comm ncement rT ust be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, coi isult with lender or an attorney before
commencing work or recording our Notice of Commencement,
5
ignature of owner/Lessee/Agent n tur of Contractor License Holder
STATE OF FLORIDA STATE C iF FLORIDA
COUNTY OF atcsecwoa¢e COUNT OF OKEECwoaM
The fo oing'insX ument was acknowledged before me The forg ng instrument was acknowledged before me i
this day of 20 Ii 5�by this" ay of DECEMBER 20 _by
ROSS A CHAMBERS ROSS A.C AMBERS
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signatu of Notary Public-State of Florida)
Personally Known x OR Produced Identification Personal) Known XOProduced I e 1fi at' n
Type of Identification ro Type of I entificatio - ppp�
� A Pu®/ VYRZL
Commission No- `•r°• +`�'• Notary t -Slate of Florid }j 116' Notary Puqq�C�� tale of Florida
•+ My Go M. plres Oct 21,20t Commiss n No. y Comm."PIA Oct 21,201 B
Commission 1b FF 150067 "s�p Commission#FF 150061
r......
Revised 07/15/2 4
REVIEWS FRONT ZONING SUPERVISO PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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