HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: '2).4. �o Permit Number:
RECEDED
Building Permit Application MAR 0 4 2016
Planning and Development Services P E W0 ITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Fence
PROPOSED I,MPROVEMENT,LOCATION:
Address: 421 Coconut Avenue, Port St. Lucie, FL 34592
Legal Description: RIVER PARK-UNIT 2 BLK 1 LOT 23 (MAP 34/22N) (OR 3453-1037)
Property Tax ID#: 3419-510-0023-000-8 Lot No. 23
Site Plan Name: Block No. 1
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED."DESCRIPTION>.OF WORK:,
Install 6 ft high wood (Board on Board) fence at rear of property approx9 If
,
CONSTRUCTION INFORMATION:
Additional work toa er orme under this permit—check"a appy:
HVAC 11 Gas Tank F]Gas Piping _Shutters Q Windows/Doors
11 Electric E] Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 3000.00 Utilities:cnSewer ]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Dagmar C P Decapite Name: Mark Lewis
Address: 421 Coconut Ave E Company: Mark Lewis Construction P.L.
City: Port St. Lucie State: FL Address: 141 South Flame Avenue
Zip Code: 34952 Fax: City: Pahokee State: FL
Phone No. (772) 878-3258 Zip Code: 33476 Fax:
E-Mail: Phone No. (561)721-5766
Fill in fee simple Title Holder on next page (if different E-Mail: micontractor@yahoo.com
from the Owner listed above) State or County License: CBC1250492
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: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x 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 first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
S
_Signa ure of Ownerf[essee/Ag6t Signature of Contrac r/License Hard&
STATE OF FLORID a STATE OF FLORIDpA�► � , nn
COUNTY OF L uGl�C' COUNTY OF . . W C,6Q2
The forgoing instrument was acknowledged before me The f r ng instru ent was ack owe dged�before me
this day of ( 20 L, by this day of 20 7�-`/�� by
(Name o)person acknowledging) (Name of person acknowledging)
(Signature of Notary P blic-State of Florida V (Signature of Notary Public-State of Flor'd )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced I )V-iaLG_ Zh Type of Identification Produced
Commission No. aypvm
Commission No. (Seal)
NOTARY PUBLIC
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C,anYrt#pp�9787 _tea+` + = Notary Public-State of Florida
Revised 07/15/2014 5/12/2019 ` Commission
#�FF 185918
% OFF�P,`r M Comm.Expires Feb 17 2019
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