HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Kiln(in f�
Date: Permit Number: 1 lU I ' UPJ
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 ✓
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 7203 Santa Clara Blvd
Legal Description: L24 B 102 Lakewood PK 9 7203 Santa Clara Blvd
Property Tax ID#: 1301-611-0053-000/9 Lot No.24
Site Plan Name: Block No. 102
Project Name: Debbie Mahula
Setbacks Front Back: Right Side: Left Side:
Install 205' of 6' wood fence (1) 4' wide walk gate
Additional work to ormed un ert is permit—check all appy:
HVAC Gas Tank as Piping _Shutters Windows/Doors
OElectric El Plumbing Sprinklers U Generator Roof
1:1Total Sq. Ft of Construction: ScFt.of First Floor:
Cost of Construction: $ 3,539.00 Utilities: Sewer[]Septic Building Height:
Name a uo� Geary e e amsJr.
Address:7203 Santa Clara L31vcl Company: Adams Fence
Ft. ierce t-L 8th St
City.. State:_ Address:
Zip Code: 34951 Fax: City: Vero Beach State:
Phone No. - Deb le Zip Code: _ Fax:32962 --99T-2039
E-Mail: Phone No. 999-2038
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: 27078
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I Ill
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 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
_Signature of Owner/Lesse Agen Signature f Contract /License Holder
STATE OF FLO STATE OF FLOR,J��
COUNTY OF COUNTY OF
The f rg�jgg instr ent was acknowledgeAuib;
before me The for o instru ent was acknowled !!ed before me
this _dayof C!(L� this yof� .2�b—by
Steve Adams Steve Adams
(Name of person acknowledging) (Name of person acknowledging)
lA v
(Sign ure of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida)
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF989142 (Seal) Commission No. FF9891
••`�� ° ELIZABETH EVANS
NotaryPublic-Slat
ELIZABETH EVANS Commission N FF 9891#2
Revised 07 ,,,l,,..,
Notary Public State of Florida .•;►a`Poe Et i1A8E ' fir` Comm.Expires Ma 4,2020
v, �" y D Y
' Commission N FF 989142 '. Nola
My qomm Expires May 'ss "
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IL NS VEGETATION M �VJTLE MANGROVE
COUNTER REVIEW REVIEW '" 'REVIEW'" ' REVIEW
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