HomeMy WebLinkAboutBuilding Permit Package 4C4 APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � - Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982.
Phone:(772)462-15S3 Fax: (772)462-1578
PERMIT APPLICATION FOR: Fence Installation
PROP05Ef�:k; llP OUEMNT LoATIO'N; .
Address; � ET_ ZOL-A
Property Tax ID#: 1 <<li N ���t � `� Lot No. �Site Plan Name: .
_ _..._._..._.._.._.._._.� Block No.
TDNProject Name: w1a
DE`fAtLED D' SCRIPTION�'QF:WC�RK �: �'
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New Electrical Meter Second Electrical Meter
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LS NSTRUOTI", 1"IUFO tI1/IATIQN
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Additional work to be performed under this permit—check all that apply;
_Mechanical _Gas Tank ___.Gas Piping _Shutters Windows/Doors Pond
T Electric _Plumbing _Sprinklers Generator _Roof Pitch
Total Sq. Ft of Construction: _ Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: Sewer _Septic Building Height:
OWNER/LESSEE z r CONTRACTOR
- __.
Name , ((. Name:Todd M Parolineq
Address: 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. 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 spacecoastgsuperiorfenceandraiLcom
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.
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p MORTtGE.G .. ,«
PPlGNEI�/EWNEEfL- f+lot Ap 4tcaEile QMPANY; Nat`AppitcaE C
Dame:
Name
-Address
Address _.
tty :. Ste CIty
Zhp phone:_ Zrp Phone
1=EE SIMISLE TITLE Hi,DER _I�ot Applicafle BONDING CC3MFANY Not Applteabi . �
Narrte
Name
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Address: address.
Ctty:: .:. Clt�r•
Pftane __..
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OWNER/CONTRACTaR AFFIDUIT Appttcatton is hereby rrtade to obI atn a pt'rmrt to dit the wrack artd.installation as�nif"rated;
(;:certify_that no,.wark ortr p isip l iora has commence i prior to the rssuance of a perrnft,;
St L c e Eo _nlaliesn�porPs n a +on"ttiatls.", tt:uidiLatlthnwzexheectYr�t-laotder-ti-bwld-;tire-�u ci —
iu rc rs,rn con rctw6th an; applitabte Home�wneCs Assderat+or� s,�bylar�rs�r X e q�anantcthatma,_v restncictr rnh+hrt,suGh^_J -
ruc urea . ease•EQnsu ,;wr yr�u`r R;om-�vvrCeCs nriation�an c'evzew::your cie�tl"�orany�restri�ctions�wlich may art 1 , __ __
•In consrcteratron of the g�antrng of thrs requested ierrrtltr I do hereby agreethat I wr(},m a(l respects,.;perfortnthe v+tork t
rn accordance with the approved pfansr tJe Flvrrda Burldrng Codes,and St.Lucie Courit}t ftrrrerdmepts>.
Thr=fo([oMpg bu l irng per.ml V'tatrons are exempt froin.undergorn�a frill concurrency'revfeW room add trorfs;.
accessory structttces,swrmmrng_potsls,fences,wars,stgns,ssreen rooms acid accessory uses_tcr anQtheC noriresrdental use<
t eco. a ce o o mentemen may resu to aytrtg cce or — `-
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►mpr`avetrients toyour propert}� A Notice of Commencement must be recorded°in the public t ecdrds of St:.
Luce GQunty a posted,on thejabstte before the fttst tnspectron :lf you niter obtain finanetng,corlsulc:. ;
vvttfa-( r an attorne ore cotnrr►enci:i workot r� rdt "t�Ur iVot of Cottiriaencotiient:;
t
S+gnature of Owner Lessee/Contractor as Agentfgr Ownr r: + ature of Confira or/L+cense Hoider::. I r
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STATE.f31=FlORIUA STATE:;aF FLORIDA
COUNTY , NTYOF' c i-
E.Srn.ts1(or affirmed);:and subscribed before5vtarn to(or affirmed}and'subscribed before me'of
P.hysual Prese ce , Onlrne Notar> ton AP), srcal Presence byhisy .
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Name:_4€persorts'makrrigsta#errient Name`i f..'person.MajJ
king°stateML-nt':
Personally Known OR Prodiace�Identification:: PersanalfyKnown OR`Praduce' ldentifleatron
Type.:of ldentiffcafion fype`of ldentrfi. on
_P odticod. Rroducea
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Commissron..Nos Lr t3�l�a'Natary!�ssst' Commission err` ` MyCamtn:ax resAP�(Sa�k
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REVtE1tUS FRONT ZONING SUPERI(ISOft. PLACVS UECETATIbN SE`ATElRTLE t IVIANGRQVE
COUNTER REVIEW REVIEW REVIEW_ REVIEW REVIEW REVIEW
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PUBLIC RECORDS OF'S7't:UGIE COUNTY, I.6RIDA. r ,
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