HomeMy WebLinkAboutBuilding Permit Application LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
r�t4� � Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1SS3 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Fence Installation
PROPOSED IMPROVEMENT LOCATION:
Address: l �r ► t' I (�.V('� t�� �"T�1 J� — ---
Property Tax ID#: Rd k—g0Q— DO21P_ WD 71 Lot No. 1 _____
Site Plan Name: ( j��011�V�t1 Block No.
Project Name: 111n 2 )rTY)VAD — --__
DETAILED DESCRIPTION OF WORK: _� ]
New Electrical Meter Second Electrical Meter
[CONSTRUCTION INFORMATION:
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: $��DD 'cy Utilities: -Sewer __Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name l /1 , >o MM Name:Todd M Paroline
Address: (r Company:Superior Fence and Rail of Brevard County Inc
City: State: Address:2778 N Harbor City Blvd#102 —
Zip Code: (� Fax: City: Melbourne State: FL
Phone No. � q ' Zip Code: 32935 Fax: 321-638-0086
E-Mail:(X�{�(S —(,�DnDVQX t vt I t ICLU. OW 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 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.
wiPPLE IENTAL CONSTRUCTION LIEN I_AW INFOkMATION:
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: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County nd posted on the jobsite before the first inspecti If u intend to obtain financing, consult
with le er r n attorneybefore commencingwork or reco i ur Notice of Commencement.
Signat r o 0 ner/Lesse /Con actor as Agent for Owner Sign of Contract /License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF L U(AC' COUNTY OF a
� Lublt)
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
P ysical Pre ence or Online No i o P ysical Pres nce or Online Nota g�1
this day of �OZO �� this day of 20?.a.bG
no
Name of person making statement. Name of person making statement.
Personally Known��OR Produced Identification Personally Known '_)6 OR Produced Identification
Type of Identification Type of Identification
Produced Pr uced
0 A '-�y o
(Sign u t Public-State of lorida ) (Si t re f Notary Pu I - a F o 'd
�_p�..• ST�?CHANI€BROOKS ,'� °oB.. ST=a4,a�=3ROOKS
Com ' sion No. o Notary P49ff�6tateof Flonda Commission No. y � $; )j
' "A Commission GG 312093 Notary P e� to of Florida
��, Commission;GG 312093
-. �k 4 My Comm.Expires Apr 5.2023 '• e.r
'`oF�°. My Comm.Expires Apr 5,2023
onded throng att a o ary,s on e rough Na Ti-, a o any ssn.
REVIEWS FRO I UPERVISOR PLANS VEGETATION SEA TI�R E M N O E
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20