HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:I D S— O �
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Building Permit Application MAR 3 12016
Planning and Development Services PER viITTUNIC
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 XXX
PERMIT APPLICATION FOR: Fence
PROPOSED IMPROVEMENT LOCATION: .
Address: 102 Riverview Drive, Jensen Beach FL 34957
Legal Description: Top of Walton w 20.67' of lot 7, all lot 8 &E 20.67' or lot 9 &rip rts on S 25'of lot 3 (or 550-2331)
Property Tax ID#: 4504-601-0007-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF-WORK:
Install approx 195 If of 4 foot high black Chain link fence at rear of residence,-with gates
CONSTRUCTION.,INFORMATION: z
Additional work to be nPrformed under this permit–check a apply:
y:
❑HVAC Gas Tank Gas Piping _Shutters (�Windows Doors
— ❑ p g L_� /
Electric 0 Plumbing []Sprinklers Generator ❑Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2000.00 Utilities: Ln�Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Ross L Jacobson Name: Mark Lewis
Address: 102 River View Drive Company: Mark Lewis Construction, P.L.
City: Jensen Beach State: Fl Address: 141 South Flame Avenue
Zip Code. 34957 Fax: City: Pahokee State: FL
Phone No. 772 n2S Zip Code: 33476 Fax:
E-Mail: %11 Phone No. 561 721 5766
Fill in fee simple Title Holder on next page(if different E-Mail: mlcontractor@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.
_Signature of Owner/ ssee/Agen ignature of Contractor/ cense Hold
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
Thef rgoing instrument was acknowledged before me The forgoing ins ument was acknowledged before me
this day of nk 20 I(CLby this 3L day of 20 by
,
(Name of person acknowledging) (Name of person acknowledging)
1
(Signature of Notary Public-State of Florida ) (Signature o otary Publi - e of Florida )
Personally Known OR Produced Identification Personally Known ORP ducep! Identification
Type of Identification Produced FL. (�•�. Type of Identification Produced X'4' S2 Cf_ 1
Commission No. mission No./ ,� „ Seal
AREN S. NIELSE :04P e�;.,� L ZA. LUGOLECKI
°' ^= commission 8 FF 115637 :2* •�=
. c Notary Public-State of Florida
Revised 07/15/2014 "" �11e 1 2, 201 8 % ?�� Commission#FF 037123
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS