HomeMy WebLinkAboutBUILDING PERMIT APPLICATION i
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AIFAPPLIGABI E INFO MUST WCOMPLETED:'FOR APPLICATION TO BE ACCEPTED "
Date: Permit Number:
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ate *
BW141-og Permit:Applicatton f "
Planning and Development Services
Building,and Cade Regulation Division Commercial _ Residential: f
2300 Virginia Avenue,Fort Pierce.FL 349$2.
Phone,(772)462-1553 Fax:(772j 4.62-1578 i
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PERMIT AFFI fCATIOfV FOR: " "
Fence Installation
I7R0 OSED ( P,( 11E I�f II l0 IOf' a h
Address -ii_ I,b� 'j�' "
PropertyTax,1.0#. 1'fit �: t�t�Ty" DOT DO i Lot Na., _ -
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Site Plan Narrie: ("S -Block,N0. E
Project Name:.
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New Electrical Meter.. Second Electrical'.Meter
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Additional workao.be performed under this permit—check all that apply:
_-.Mechanical _Gas Tank Gas Piping. Shutters _UVindoyv.s/Door's Pond
Electric _"Plumbing _Sprinklers _Generator Roof Pitch
Total Sq.Ft of"Construction:; Sq. Ft.of First Floor:
Cost of Construction:$. Utilities:. _Sewer _Septic Building Height:" ;
,t' *�� � $i a 7r -� �:;>� •^'y,�. �sy.£ -
OW1ER LSEE COI IAC 'OR Y � ,
S«,'� >;` .4:7.@.., ,akx:3 <rxs a ,7ses�" .,d,. „i„,,`,r• "4. �,»�, ,i, z,3- a:,a
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Name U Name Todd M Paroline
Address: �.� '�'"- _ i Company Superior Fence and.,Rail pf Brevard County Inc
city: I State: . i,Address:27.78"N Harbor City BI,•Vd#102•
Zip Code:.. f y " Fax: City' Melbourne State;FL
Phone No: .. Zip Code: 329a5 i Fax: 321-638-0086
Phone No 321'-636-2829
Fill In fee.simpleTitle Holder On next page(if different . E=Mail spacecoast@superiorlenceandrail com
from the Owner listed .above). I State or County,License 313,37 i.
If value of construction is 2500 or more,a RECOROED Notice of Commencement,is required.
If value of HAVC is; 7,500 or more,;a RECORDEt);Notice of Commencement is required..
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DESIGNER/ENGINEER: Not Applicable iltl{}RTGAGE COMPANY: _ Not Appllca6ln
Name-
Name:.
am ,.
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f; Address
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Ad dress:
'City. State: City:: _ State:
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' 'Phone Zip:, Phone:, I
FEE'SIMPLE TITUE HOLDER: Not Applicable BONDING COMPANY. _Not`Applicable -
Name: Name: {
Address: Address:
City:. _ - Ctty .
Zip: Phone: Zip: " Phone -
OWNER/CONTRACTOR AFFIDVIT:-;Application is hereby made to obtain a permit to do the work and mstaNationas indicated.
G certify that no work or:.installat on 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 fo build the subject structure. `
which is in confl ct,with any applicable Home Owners Association rules,bylawsor 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.
16 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 Buildi'ngCodes and St.Lucie County Amendments.,
The following building permitappRcations are exempt from undergoing;a full concu.rrency 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 Gominencement may "result in.paying twice for
improvements to:your property. A Notice:of Commencement must:be recorded in the public records of.�St. l
Lucie Cou _°`y a.nd'pos d on the jobsite before the..first inspec `0� If you.irate" Qto obtain.fin,arrcing,consult
wi a or.an.a me before comme:ncin work or r r I v r No ' of Commencement.
Sig ature of Owner(Lessee/canteactor as Agent,for Owner signature of Contractor/license Holier
STATE OF FLORIDA STATE OF.FLORIDA
COUNTY OF COUNTY OF . '�VLt,
;Sworn i to.(or affirmed)and subscribed before me of ' Sw rn to(or affirmed)and subscribed before me of
yslcal Pres ce or. Online Notar t• ysical Pr" ce r Online Notari7,
this day of -w y t is day of %by
Todd M Paroline Todd Partline
Name of person making statement, 1 Name of person making.statement. ' I
Personally Known OR Produced Identification j, Personally Known, OR Produced Identification
Type,of Identification. Type of Identification
P ,duced_� duced
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{ g a ur of ( n e f.Notary Public-Stat f Flonda)
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Notary Aubnc. Ste ri<fa £3RooStS.
f o mission` �I C mission.Na:. J 5ii j
ct�rE' 55tor.x G 3,120 3 o ubiic State df Florida
aRfl My comet.ExpiresApr5,2623 z Notary f
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIO $� h'N tiosxatNotarYAssq
COUNTER REVIEW REVIEW REVIEW REVIEW EW REVIEW
DATE
RECEIVED
" .DATE
"COMPLETED .
Rev.