HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:_1��`1 Permit Number: Y1 O} -0355
RECE11.'7D JAI 19 237
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: Fence
PROPOSED IMPROVEMENT LOCATION:
Address: o Z ec
Legal Description: z-
Property Tax ID#:_ 3C� lC) CS J Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be erformed under this permit-check a appy:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers E Generator 11 Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
00
Cost of Construction:$ ISO y Utilities: _Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name ',Tatwi-e-,5r PO I/i 6n Name: Scott Peters
Address: 3 3 11 5 Company:All Indian River Fence
City: f-T. A-c/,cc-e- State: F! Address: 790 SW Airoso Blvd.
Zip Code: 3 t/9 V/ Fax: City: Port Saint Lucie State:FL
Phone No. 7 7 R S9S- A/YS' Zip Code: 34983 Fax: 772 878-8283
E-Mail: Phone No.772 340-1045
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:#26030
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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 Count makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or andpcovenants 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,1 do hereby agree that 1 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/Agent/Lessee Sign ture of Contractor/License Holder
STATE OF FLORA STATE OF FLORIDA
COUNTY OF S t- c COUNTY OF 0"
The forgoing instr ment was acknowledged before me The forgoing instrument was acknowledged before me
this 1° day of 4'N 200 by this V day of _Sg,CN .2011 by
S[.aTT
(Name of person acknowledging} (Name of person acknowledging)
(Signature of Notary blic-State of Florida) (Signature of Notary Pu 61ic-State of Florida)
Personally Known )q OR Produced I Personally Known A Produced Identification
Type of Identification P 9ENINn MARir GNENS Type of Identification Pro c a
,••••'r• z
rs MY COMMISSION#GG o22023 ii� •,_-sDEANNAMARIE GIVENS 1
Commission No. ly— "'= IX )pmber1s.2020 Commission NO. M= r�'�SSION#GG 022023 f`
%'�€of�,o:•' BondedThruNotary PebilcUnderwntors
December 16.2020
'•'.,P,c►ito.••
Banded ThtuNotary PubftUndonwiter—
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS