HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Lzels log
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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
PROPOSED IMPROVEMENT LOCATION: �-
Address: 5211 Indian Bend Ln, Ft. Pierce, Fla. 34951
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Legal Description: Holiday Pines s/d , Phase II Al Lot 197 (Map 13/12S) (or 752-2856
Property Tax ID#: 1312-800-0028-000-9Lot No.197
Site Plan Name: n/a Block No.
Project Name: STEPHENS
Setbacks Front 76 Back: 0 Right Side: 0 Left Side: 0
DETAILED DESCRIPTION OF WORK:
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Replacement of existing fence with 302' of 4' Green Vinyl Chain Link Fence;
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CONSTRUCTION INFORMATION: =
Additional work to be nertormed under t is permit—check all appy:
11HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers 1:1 Generator E] Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 3200 Utilities:Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR •d'
Name Ronald Stephens Name: Ross A.Chambers
Address:5211 Indian Bend Ln Company: Adron Fence Co
City: Ft. Pierce State:Fl Address: 1132 NE 12th St 'I
Zip Code: 34951 Fax: City: Okeechobee i State:fL
Phone No.772-595-1681 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
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: N � '
DESIGNER/ENGINEER: _Not Applicable M TGAGE COMPANY: _Not Applicable
Name: Name.
Address: Addres
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE LDER: —Not Applicable BONDING COM NY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count 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.
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
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STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF OKEECHOBEE COUNTY OF OKEECHOBEE
The forgoing instru!�ent was acknowledged before me The forgoing instrument was acknowledged before me
this _R day of A/ V 201k—by this 30 day of NOVEMBER 20 by
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ROSS A.CHAMBI�RS ROSS A.CHAMBERS
(Name of person acknowledging) (Name of person acknowledging)
(Signature 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 Produ m—f,�a of Identification Pro _ �. ..
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""""' DOREEN ELARD!
.`ova ,� ava �. DOREEN ELARDI
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�olzlna ¢ ?2# �= r Pub!'.--State of FI rift mission No. torzvts ;r. ,o: No(����b!'.--State of Florida
Commission No. , S�lil) Y
x ��•E My Comm.Expires Oct 21, 018 ='a ; My Comm. Expires Oct 21,2018
,: - c, Commission # FF 1500 7 Commission #FF 150067
"�����" Bonded Through National Notary Assn. �tional Notary Assn. d
Revised 07/15/2014 {
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION I SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW i REVIEW REVIEW
DATE
COMPLETE
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INITIALS ,