HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAN APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date Permit Number
see,at @j. • Building Permit Application
Planing and Development Services / Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce Ft 3498.2
Phone (772) 462-1553 Fax: (772) 462-1578 - -
PERMIT APPLICATION FOR: Fence Installation
PROPOSED IMPROVEMENT LOCATION:
Addre1�1 ° shh2' 1418 Property Tax ID## [ Lot No
Site Plan Name: Block No 2
rec»e. foCe Ip3lC\\chics-Gc Lala.er
DETAILED DESCRIPTION OF WORK: i
1 .2 ' - C, " ' " • •
L-c5 ale _Ca\ t- f • .9g.e
New Electrical Meter Second Electrical Meter I CONSTRUCTION INFORMATION. : , I
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 First Floor,
cost of construction.s 24)150 e Utilities. Sewer Septic Building Height
OWNER/LESSEE: CONTRACTOR:
Name '
. - Nam@ Todd M Parolin ' '"'"'�� b e c Company_ Superior Fence and Rail of Brevard County Inc \ sateL- Address 2778 N Harbor City Blvd #102 o [S Cit. Melbourne state.fl_ Zip code. 7 Fax.
romeo.24 3\71-225%, Zip Code. 32935 a 321-638-0086
£-Mail hone N6 321-636.-2829
Fill in fee Simple Title Holder on next page if different £-Mai[ spa0000as@sup0riorfenceandrail.ot
from the Owner listed above) State or County Licen, 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 RE CORDE D Notice of Commencement is required ' -
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
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
certify that no work or installation has commenced prior to the issuance of a permit
St Lu<ie Ccur>tX mokc, no roprcsontatlon that is granting • permit w,11 author"• th�rm,t holder 10 build 11-.., sub)<<! wuc:turo which is in_conflict with_any sipplicable Home Owhers A9Mt"onrules bylawsoranlcovenants that may restictor prohibit such structure.Plese consult with our Home Owners Associatic and review your deed for an restrictions hid may 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 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 est& another nonresidential ug
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 an�ted on the jobsite before the first inspection. If you mt end to obtain financing, consult
with lender or orney before com men ems work or recor ing Ir Not,ce of Commencement
- A - t (
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
st_orroRiA _y Luc< smAt or om0Av_l) ucK COUNTY Or O couNrY or G.'
to tor affirmed) and subscribed before me of 9to(tor affirmed) and subscribed before me of
-a.vikal Preser><:e o, __ Onllr,e Not•ma1>0n �y;,cal Prl)eo or __ 0,,1,ne Notor,.ation ihi rot1C ot r this day ot C202k b
Todd M Paroline Todd M Paroline
Name of person making statement Name of person making statement
Per,.onallv Known LOR Produa,d ldent,l,ca\ion __ Personally Known LOR Produced Identification
Type of identification Type of Identification
Pll)..:td Produced �· - iii -·� '" @ (Signature of Notary Publ[g tl9$olns9ON HH 0903928 11naturo of Not;wy P"bllc· S . a DPIRES;FolNuory=I ' i. . EXPIRES. Fetty 1, 2025 i Boded helot.y. Coenmission No. odd%e. mmission No Ho¥ H04t
REVIEWS FRONT 0NING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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