HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/1/2015 Permit Number:
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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
PROPQSED I:M,PROVEMENT LOCATION.
Address: 5213 Hickory Drive Fort Pierce 34982
Legal Description: INDIAN RIVER ESTATES-UNIT 07-BLK 51 LOT 37 (MAP 34/02S) (OR 3631-455)
Property Tax ID#: 3402-608-0431-000-9 Lot No.4&5
Site Plan Name: Block No. 43
Project Name: Fence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
. .
Fence Repair (Rotten) 6' high 1681f with 2 gates.
CO"NSTRUCTIM INFORMATION
Additionalwork toe e orme un er this permit—check a appy:
HVAC E]Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric 0 Plumbing Sprinklers I Generator 1:1 Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 1,500.00 Utilities:InSewer Septic Building Height:
0.1NNER%LESSEE CONTRACTOR a
G �. «.s- a n : � sd
Name Rubens C Cocca Name: Roderick Waller
Address:5213 HICKORY DR Company: Sunrise City CHDO, Inc.
City: Fort Pierce State:FL Address: 800 Virginia Ave Suite 61
Zip Code: 34982 Fax: City: Fort Pierce State:FL
Phone No.305-215-9980 Zip Code: 34982 Fax: 772-907-0420
E-Mail:rcocca@aol.com.br Phone No. 772-201-2850
Fill in fee simple Title Holder on next page(if different E-Mail: rodwallerl@gmail.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 CONSTRUCTION LIEN LAW INFORMATION ,' m`"
�. ,_
_.
DESIGNERANGINEER: _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
commenqing wok or recording our Notice of Commencement.
(47�J L-S�
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_Signature of Ow er/Lessee/Agent Signature o ontractor/Lice se Holder
STATE OF FLORIDA I STATE OF FLOgDA Lvc\
COUNTY OF S-'C . L oc �� COUNTY OF e
The forgoing instrument as acknowledged before me The forgoing instrument was acknowledged before me
this�. day of 20 Eby this day of At V'%\ , 20 W6 by
C. C_�c. �\ti' {�o�s�c�ck Wad\-k
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida •. PGtV oFto�� (Signature of Notary blic-State of Florida) NS
EPNN State 6 20 NSF GNE F�otida
Personal) Known OR�__,Wd ced Id tri C.
Qeo�a�g1 rsonall Know _�R d ' ced Identp'P tdor�tate°�j6 2p16
Type of Identificatiori Pr u e� P,'; N°ta��mm � e of Identification Pro`duceG} �'P B'��,, t,° ExP 5a�
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Commission No. �e�s`, c (S �t�`pU9� Commission No.1� �5$ 0, =q (�Om�`(ou9hNau a
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS