HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
LU 1 r
D Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 3498"?
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Fence Installation
Address:
W
Property Tax ID #I: Lot No. I�(�
Site Plan Name: ponnd-1p Block No. _
Project Name: h
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: $ L02po, QO
`_ Windows/Doors — Pond
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Name—DO22ii)f2 -r(iS n _
Address:5_UVS rVGt_f'" t�\V(
City: T1__ FIeyCie _ State:
Fl-
Zip Code: 02— Fax:_
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
L.U@I!IKX• IUK:
Name: Todd M Paroline
Company: Superior Fence and Rail of Brevard County Inc
Address: 2778 N Harbor City Blvd #102
City: Melbourne State: FL
Zip Code: 32935 Fax: 321-638-0086
Phone No 321-636-2829
E-Mail spacecoast@superiorfenceandrai1.corn
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 CONSTRUCTI N LIEN LAWJNFQRMATI(
N:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: V 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.
51:. 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 TOO NER' Your failure to Record a Notice of Commencement may r ult in paying twice for
improveme s to your property. A Notice of Commencement must be orded in the public records of St.
Lucie Coun an poste on the jobsite before the first inspect . If u i end to obtain financing, consult
with I d or a attor e before commencin work or rec r tice of Cornment.
Signa of Owner/ Lessee/Contractor as Agent for Owner
Signa e of Contractor/License Holder
STATE OF FLORIDA
STATEOF FLORIDA,r�)COUNTY
W.l�l
OF J�P�
S�U.,
COUNTY OF-
S n to (or affirmed) and subscribed before me of
sical Pres cer Online Notariz io
thik day of-�8�t3-by (_j
V
S n to (or affirmed) and subscribed before me of
r hysical Pres ce or Online Notarization
thisi day of Rffi!by 2(��
Todd M Paroline
Todd M Paroline
Name of person making statement.
Name of person making statement.
Personally Known l`uki__ OR Produced Identification
Type of Identification
PrNced?U
Personally Known _ OR Produced Identification .,-_-__-_- -.
Type of Identification
Pr ced
(Si a u obli tary P c State o Florida
(Sig at of otary Public- State of or a
' 1tY_?v' -., STEP iANI ROOKS
pt
Com ission No. r Notary PdbRa tate of Ftorida
Commission N GG 312093
EesA r 20
.�< Y Pua •., STEPH IE B OOKS
° v •�` ow Publ' �E
Commission No. y , of Florida
q' o`l Commission ; GG 312093
_ __ M Comm. Ex ire r 5 2023
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