HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _ Permit Number: _
Building Permit Application
Planning and Development Services
Bw/d,ng and Code Regulation Division Commercia I -----
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Project Name:
DETAILED DESCRIPTION OF WORK: c
New Electrical Meter Second Electrical Meter _
I CON�UCTION INFOltMATIOf':. ::
Additional work to be performed under this permit- check all that apply:
Mechanical
Electric
Gas Tank
_ Plumbing
_ Gas Piping
_ Sprinklers
Shutters _ Windows/Doors
Generator Roof
Pond
____ Pitch
Total Sq. Ft of Construction: _
Cost of Construction: s W()() Sq. Ft. of First Floor:-----------
Utilities: _ Sewer _ Septic Building Height: _
Name
Ad dress ::--�U..1..,.�L>..>&>"----l.!'-"""""----'-"'-"-�=-
cnv 9::1'\e VU'; State,(!_
Zip Code, ,?}(?f:J \
Phone No. _
E-Mail: _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Todd M Parohne
Company: Superior Fence and Rail of Brevard County Inc
Address. 2778 N Harbor City Blvd #102
City: Melbourne State:�
Zip Code: =3=
2
9:::3::5:._ Fax: 321-638-0086
Phone No 321-636-2829
E-Mail spacecoast@supenortenceandra1l.com
State or County L1cense�3_
1
3=-3=-7 _
CONTRACTOR: c
Fax: _
lf 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.
SUPPtEMENT�LCONSTI\l,JCTION�·LAW IN�M�TIOfi" .
. 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 AFFIDVIT: Apphcanon rs hereby made to obtain a permit to do the work and installation as morcatec
I certify that no work or installation has commenced prior to the issuance of a permit.
St. _Luc!e County makes no representation that rs granting a permit will authorize the permit holder to build the subject structure which rs tn conflict with any applicable Home Owners Assoctatlon rules, bylaws or and covenants that may restrict or prohrbrt 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, mall respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applicatmns are exempt from undergoing a full concurrency review: room addrtrons,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another ncn-resrdentral use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and pos don the jobsite before the first inspection. If you· end to obtain financing, consult
with lender n ne before commendn work or recor · o ice of Commencement.
STATE OF FLORIDA � LLlcJ ) COUNTY OF r.., _g STATE OF FLORIDA Qi I , • , . . ,
COUNTY OF l,,,X
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MANGROVE
REVIEW
VEGETATION
REVIEW
Name of person making statement.
Personally Known }(
Type of Identification
Produced �=----:_,"'
Sworn to (or affirmed) and subscribed before me of
�Pfys1cal Prestnce or Online Notarization
this JJ,t_ day of ,J� , 2020 by
::R:cl:! (Y) ?a w\ ,l,,(,c..V
PLANS
REVIEW
SUPERVISOR
REVIEW
OR Produced Identification
REVIEWS
DATE
RECEIVED
Name of person making statement.
Personally Known )(
Type of rdenuncanon
P. duced,�----------�
rn to (or affirmed) and subscribed before me of
hys1cal Prese,��•or· Online Nctanzanon
day of� ,2020 by
:Jfdo . rn tO,v(5I Mi Q ;
DATE
COMPLETED
ev.