HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
`F1'
Ir n tDD Building Permit Application
Planning and Development Services —�
Building and Code Regulation Division Commercial Residential
2300 Virginio Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Fence Installation
Address:
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Properly Tax ID #:�
Site Plan Name:
Project Name:
New Electrical Meter Second Electrical Meter
Lot No. kv
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sci. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Al I Utilities: —Sewer —Septic Building Height:
Name GG
Address: tt
City: rbft" State:n_
Zip Code Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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@superiorfenceandrail.com
State or County License 31337
it vawe or construcrion is [suu or more, a HICORDtD Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL. CQN"STRUCTIQN. LIB"N LAW INFI;?RMATI?N.
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ 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.
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 lender or an attorney before commencing work or recordin our Noti e of Commencement.
Sign e of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA QQ1�
STATE OF FLORIDA
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orn to (or affirmed) and subscribed before me of
Ph sical Presence or Online Notarization
this day of _ , QQ_X • by MA
S orn to (or affirmed) and subscribed before me of
ysical Pre e r Online Notarization
this day of z6•,�6-by
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Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known _� OR Produced Identification
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Type of Identification
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