HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date Permit Number:
s Leet -, tC:tQJj ,- I - '
' u t ·- Building Permit Application
pluming a Development Services ,,,-, Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Font Pierce Ft 34982
Phone: (772) 462-1553 Fax. (772) 462-1578
-- PERMIT APPLICATION FOR: pence Installation
PROPOSED IMPROVEMENT LOCATION: u b ea 8 £5 Address
Property Tax ID #f 2\-500-00La CLO±o Lot No H
Site Plan Name Block No. z
roectNc.Acne& al\ah~n- UR Lua\ho& I DETAILED DESCRIPTION o��K %s% • a%ee • • I toil.I @j' G
New Electrical Meter Second Electrical Meter
[ cowsreucno INFORMATION
,c - I • r» ,
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 Sq. Ft of Construction Sq. Ft. of Fiest Floor
costot construction. s (/?1/,'7le Utilities Sewer Septic Building Height:
OWNER/LESSEE CONTRACTOR:
Name l .•, ' Name. Todd M Paroline
Address r - Corpan Superior Fence and +Rail of Brevard County nc ow.foe cc< state. Addreg. 2778 N Harbor City BNd #102
z code.21re1° pa Cit Melbourne sate.f_
more6.12L 3279- 7290 Zip Code 32935 Fae 321-638-0086
E-Mail a/alpru\focal.cam Phone 1N 321-636-2829
fill in fee simple Title Holder on next page ( if different E-Mail spa0000as1@upOriorfonceandrai.0on
from the Owner listed above] State or County Liceng6 31337
, ---- f value of construction is 2500 or more, a RECORDED Notice of Commencement is required
f value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. 4 ,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGIN~KR- -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
l certify that no work or installation ha4 commenced prior to the issuance of a permit
St. Luc"' Couo� makes r><> ropresenmlon that sgrating a p,:rmlt will autho,l,o the {Jrm� h<>lder to build thoJ.ubje<t StructulO which is in_conflict with any_applicable Home Owners Association_rules, bylaws@"apglcovenants that may_restrict ~r prohibit such structure. lease consult withi u Home Owners Association and review your ed an restrictions which my apply
In consideration of the granting of this requested permit, I do hereby agree that will, in all respects, perform the work in accordance with the approved pans, the Florida Building Codes and St. tuie County Amendments
he 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 es to another nonresidential 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 pr an attorney before commencing work or recardi your Notice of Commencement.
, DU .±.- Signature of Lessee/Contractor as gent for Owner
SATE Or FLORIDA,_ , Luce s1Are_or homo» \ Lucie couNrY or .ON COUNTY Or l
�n to(..- a!firm<td) ond sub><:•lbed before mo of "Poter tfimes) an subscribed before me of
jhyslcal P"sf>'"" __ Online Notar1m1on :m•lcal P,esente or Onl,no N01ari1at,on
this Ledy of CC.202) i ·et DRCo
Todd M Paroline Todd M Paroline
Name of person making statement Nmne of person making statement
Porsonallv KnoWI\ _LOR Produced ldent,�cation _ Personally Known LORProduced Identification ype of identification Type of Identification
Produced Produced
Kl:. hk £dss 3.e (Signature ol Noury Pu;.Stat<t ii ' Signature of Notary Public- State
C�m•••� ,.\jl\'®'j,8;�"'°\l-lJQ\;fj,S := MY COMMISSION 09392
EXPIRES. F ,202S PIRES February 1,202$ 0odd hr.Noy
REVIEWS FRONT ZONING SUPERVISOR VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED � l - DATE
COMPLETED , - 6w. 5/6/2¢
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