HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
r �r
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierre FL 34982 —7—
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Fence Installation
Address:
Property Tax ID #: I ` 1 "j 7 fT�V I — 0 1 20p� DW Lot No. N
Site Plan Name:' a n /�,�r�,..y��'wA'w�'tZ��`�'i�� Block No. is
Project Name: ut 11'V 1lA,t,�Vy < (� Re ,
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric , Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 1 04—I•,,) ,0
_ Generator
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: _-Sewer _Septic Building Height:
Name LVf q UM C7C7 , Name: Todd M Paroline
Address: Z (( � n Company: Superior Fence and Rail of Brevard County Inc
City: 1 State: ti, Address: 2778 N Harbor City Blvd #102
Zip Code: — Fax: City: Melbourne State: FL
Phone No. Zip Code: 32935 Fax: 321-638-0086
E Mail: Phone No321-636-2829
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.
SUPPLEMENTAL'CONSTRI I010N'�LIEN
L;4W .INFORMaTlr
hlr
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City:
Zip: Phone
_State:
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 and post d on the jobsite before the first inspection. If you intend to obtain financing, consult
with len or a at me before commencing work or reco ur ' tice of Co encement.
Signature of Own / Le, ee/Contractor as Agent for Owner
Sign&Lire of Contractor/L' ense Holder
STATE OF FLORIDA 1 1 I
COUNTY OF �1�l�eJ
STATE OF FLORIDA Lucie,
COUNTY OF Luci ',
rn to (or affirmed) and subscribed before me of
Physical Presence or Online Notariz,{{��Ltion
this day of� �0 by<U�
S orn to (or affirmed) and subscribed before me of
Physical Pres ce o Online Notarization
this �day ofe�e bv20Z1
Todd M Paroline
Todd Paroline
Name of person making statement.
Name of person making statement.
Personally Known _>_ OR Produced Identification
Personally Known %� OR Produced Identification
Type of Identification
Type of Identification
oduced
Produced
(Si e of Nota u 4,;-,, ate of l 4R KS
4, =-`ear; Notary Publ state of Florida
�t a Commissiqq 312093
Commission No. Comm. Ek RNhnr 5, 2023
F�; .'
Bonded through National NO Assn.
(Sin re f Notary Public St e f F or'd
��yr v�B., STEPHANIE BROOKS
Commission No. : o G „� . y Public - S(Reelylorida
'
i.,: w; 5g Commission GG 312093
'�� `'o`` M Comm. Expires Apr 5, 2023
Bon
ed through National N
ary ssn.
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REVIEWS FRONT ZONING SUPERVISOR
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COUNTER REVIEW REVIEW
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