HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:11I�''�S�a.
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: AiC I t W),- _Ty Cts C, 6 vt` F t � c L
Legal Description:
Property Tax ID#: - - LA -SCO I- ()G0J Lot No.�__
Site Plan Name: V �'n-n{� Block No.
Project Name: �r V �
Setbacks Front Back: Right Side: Left Side:
ED TAILED DESCRIPTION OF WORK: "
CONSTRUCTION INFORMATION:
Additional work to be performed under t ispermit-check all that appy:
❑HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction:: 5Ft. of First Floor:
Cost of Construction: $ ` " X Utilities:cnSewer❑Septic Building Height: _
F OWNER/LESSEE: CONTRACTOR:
rAd
e Name: Todd Paroline
ress: (' I Company: Superior Fence and Rail
City: e1/C State: Address: 2778 N Harbor City Blvd#102
Zip Code: Z Fax: City: Melbourne State:FL
Phone No. X7,2— — Zip Code: 32935 Fax: 321-638-0086
E-Mail: Phone No. 321-636-2829
Fill in fee simple Title Holder on next page ( if different E-Mail: spacecoast@superiorfenceandrail.com
from the Owner listed above) State or County License: 29589
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 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 y u intend to obtain financing, consult with lender or an attorney before
commepi4ng work or cordi Our Notice of Commencement.
r
s
_S nature of Owner/Lessee/Agent Sign atur on rac or/ icens de
STATE OF FLORIDASTATE OF FLORID O /
COUNTY OF W C SW COUNTY OF `AA O'C
The forgoing instrum knowledge before me The forgoing instr grit w acl nowledged before me
this�day of 20 nby this�day of V 20 L by
(Name o person acknowledging) (N me of person acknowledging)
(Si ure of k4otary Public-Statq oo da ) (Sig r otary Public-State ncla )
Personally Known OR Produced!Aentification Personally Known 'YC OR Produced Identification
Type of Identification Produced _D( Type of Identification Produced
Commission No. (Seal) Commission N pHAN1EBRwaos
_t:�y rY4'' Mr XpIRES Apr#5 2 ers
MY Cph1MISS10N N FF 217128 0, Rig' Bonded tutu
Revised 07/15 EXPIRES:Apri15,2019
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REVIEWS ONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS