HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
S)'l"; tr.oCll�IT!r --,�
� . ., -- Building Permit Application
Plannmg and Development Setv,ces
Buildmg and Code Regulation Division Commercial Residential )G
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Fence Installation
.PRO�SED IMPROVEMj;NT LON TION; .. �� - (\ IV {? LA A Jl,Py(;" r, - :t Address: .-J n1 "\ '
Property Tax ID#: 131'1- �-0130· C(D-l;? Lot No. \ 'l. "I
Site Plan Name: I(()� W1edeme1f'1r Block No. •• " Project Name:
[_DET�io 0Es�RiPr10N OF WORK: -sz ·� S Ac ' -:-. =i - .. - ·iz,
lt,;M11 l'iS"'' li. f"J_t.:fu,r:L 1Dl\-4·�.dl- �'Di) 9euu
New Electrical Meter Second Electrical Meter
CONSTRUCTION'INf<)RMATION: - - .;;�;« r, jl•: h�11,LlY/-� .. •
Additional work to be performed under this permit - check all that apply:
Mechanical Gas Tank _ Gas Piping Shutters Windows/Doors - Pond - - - -
Electric _ Plumbing Sprinklers Generator Roof Pitch - - - -
Total Sq. Ft of Construction: Sq Ft. of First Floor:
Cost of Construction: $ 1tiatl Utrlrties: Sewer _ Septic Building Height: -
· OWNER/LESSEE: .. - . cnNTRACTOR: - +y· - ::::ss��C,tvE Name: Todd M Parolinc
Company: Superior Fence and Rall of Brevard County Inc
Address· 2778 N Harbor City Blvd #102 City: 5:: jfKf', State:El
Zip Code: ,Wf:51 Fax: City: Melbourne State:�
Phone No. 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@superiorienceandra1l.com
from the Owner listed above) State or County license 31337
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 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:
OWNER/ CONTRACTOR AFFIOVIT: Apphcation is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or mstattanon has commenced prior to the issuance of a permit.
St. Lucie CountX makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in con ict 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 restncncns 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
STATE OF FLORIDA 3- \ COUNTY OF U(,,lV
S n to (or affirmed) and subscribed before me of
Physical Preser,:e or __ Online Notarization IL day of s.J.Y ne .t , 2020 by
Todd tYl t'a,vou.N;
Name of person making statement.
Personally Known 'i.
Type of Identification
Produced,_:--------,--
STATEOFFLORIDA (\\ LU"" COUNTY OF,----"�-"----'-"--"'--'�
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S:'f)n to {or affirmed) and subscribed before me of
Physical Presepce or Online Notarization
thisJ2..dayof vu� . 2020 by
:I <rld tv:\ tWoLLn v
Name of person making statement.
Personally Known () OR Produced Identification _
Type of Identification
Produced,_---:-----:-..,---
OR Produced Identification
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
ev.
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW