HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Name N AW I r ►i � (:'WLU IT
Address: n r
City: 1"f �i'��� State: F
Zip Code:��� Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Residential X
Name: Todd M Paroline
Company: Superior Fence and Rail of Brevard County Inc
Address: 27/8 N Harbor City Blvd #102
City: Melbourne State: FL
Zip Code: 32935 Fax: 321-638-0086
Phone No 321-636-2829
E-Mail spacecoast@superiorfenceandrail.com
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.
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:.
BONDING COMPANY:
Name:_
Address:
City:_
Zip:
Phone:
Not Applicable
State:
Not Applicable
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 and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with Jerlder/r w attornev before commencing work or recoj: ling your Notice of Commencement.
SigpKtae of Own r/ Lessee/Contractor as Agent for Owner
Sig t e of Contractor/License Holder
STATE OF FLORIDA �1- (
STATE OF FLORIDA
COUNTY OF
COUNTY OF
S n to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
P ysical Pre nce r Online Notariz ti
� P ysical Presence or Online Notari io
this � day of ��9i6 byl
this,n day of .�8i�0 by�
Name of person making statement.
Name of person making statement.
Personally Known t OR Produced Identification
Personally Known )6 OR Produced Identification
Type of Identification
Type of Identification
Produced
P duced__
n of N a ' 0c- to E811AI 16A S
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Notary Public
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(Si ure f Nota f? i Stat I I�
• State Florida
Omission
_°.•;��: No Public • StaI Florida
_o` Commission N G 312p93
No. ' . Expires 1r��2023
"" Commission R G 3 093
Commission No. Comm. Expi�(ce?�, 2023
Bonded through National Notary Assn.
Bonded through National Notary Assn.
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DATE
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DATE
COMPLETED
ev. 5/6/20