HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:---------
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ---- Residential ----
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED li'!>1PROV!MENTtOCATION:
Address: Vi (.,
Legal Description: \t(l{ CLY) ( \VeJr CSbJfeS -UY)\\: 0\ - tiJl. � l It3.o
Property Tax ID#:---------------------------
Site Plan Name:------=::------------------------
Project Name: lj)�� Q\J lt\e_.,
Setbacks Front Back: Right Side: Left Side: _
Lot No. _
Block No. _
mona wor
DHVAC
DElectric
D Windows/Doors D Generator D Roof
S9,:l!; of First Floor:
Utilities: LJ Sewer D Septic Building Height: _
State or County License: _2_9_
5
8_9 _
State:�
Fax: 321-638-0086
City: Melbourne
Zip Code: _3_
2
_
9
3_5 _
Phone No. 321-636-2829
E-Ma ii: spacecoast@superiorfenceandrail.com
Name: Todd Paroline
Company: Superior Fence and Rail
Address: 2778 N Harbor City Blvd #102
CONTRACf"OR:
Name-"'�..f=,ai:::,;���1.-l,....l�._.....,..--------
Add ress :�"'-4�:..+-.-""-4,,.""-........,..u..::....,.._,,._,,�------,..--
City: _ __._.,__.,J.--1�-'=-"........,,�------ State:
Phone No. _
E-Mail: _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Total Sq. Ft of Construction: _
Cost of Construction:$ 4)�
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
_ Not Applicable
Name: -------------------- Address: ------------------- City:-------------- State: Zip: Phone: _
MORTGAGE COMPANY:
Name: _
Address: ------------------- City: State:
Zip: Phone:------------
_Not Applicable FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: _
Address: -------------------
City:------------------- Zip: Phone: _
BONDING COMPANY:
Name: _
Address: _
City: _
Zip: Phone:-------------
fa� ______________________s
Signature of Contractor/License Holder _ Signature of Owner/ Lessee/Agent
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencin work or recordin our Notice of Commencement.
STATE OF FLORI� lli COUNTY OF L st (,..le) STATE OF FLORIDA �L \_M ) COUNTY OF � C.,lQ
Th_e ]R;Joing instrue:f::tobJowledged,,be!ore me
this -...i::1...:_ day of Jc, 20 JJ..f,fy
The fo\going instruR11�as1acknowledgU&efore me
this day of \\J\J V , 20 by
(Name of perso acknowledging)
Personally Known OR Produced ld�ification .)l_
Type of Identification Produced PL,:'Uc...,.
Commission N, ,, �07.:· ,, £"'::PHA.t.11EBf(�?;fll -1 I /t··f.:.i\:'" MY GGMMISSH)N j rr �171213 h ',:;� /1 · · .o -Es: Mr!\ 5, 2019
(Name of person acknowledging)
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS
NOTICE OF COMMENCEMENT
ST A TE OF Florida
COUNTY OF �El q--[U (LJ )
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes,
the following information is provided in this Notice of Commencement.
I.
2.
3. Owner information:
a. Name and address:
b. Phone number:
c. Name and address of fee simple titleholder (if other than owner):
4. Contractor:
a.
b.
Name and address: Superior Fence and Rail of Brevard County, Inc. 2778 N Harbor City Blvd, Ste 102, Melbourne, FL 32935
Phone number: 321-636-2829 ---------------------
c. Phone number: �n�
!
a�-----------
Lender:
a. Name and address:
b. Phone number: �n�
/
a�------------------
Persons with the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 71:
Florida Statutes:
a. Name and address: _n_/_a _
b. Phone number: �n=/�a�------------------
ln addition lo himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1.
Florida Statutes:
a. Name and address: �"=/=a�------------------------------------
b. Phone number: �n�/�a�------------------
Expiration date of notice of commencement (the expiration date is one (I) year from the date of recording unless a different date is specifii
n/a
7.
9.
5. Surety:
a. Name and address: _n_
/
a _
b. Amount of bond $�D-L-a�-------------
6.
8.
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMEN
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN
IN YOUR PA YING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECOR[
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WIT
LENDER OR AN ATTORNEY BEFORE COMMENC!N7�NOTICE OF COMMENCEMENT.
Signature of Owner or Owner's Authorized Officer/Director/Partner/Manager
Signatory's Title/Office ___.,O!�vrrl.._�,,.YJL->,J2
c
c
J
,&."-k::
�
---------------
x
S n I e o Notary Public - State
Print, type, or stamp commissioned name of Notary Public
Personally Known_____ �duced Identification
Type of identification produced--+�
-
=-.,...._..._-�----------
Verification pursuant to Section 92.525, Florida Statutes
Under penalties of perjury, I declare that I have read the f/ and that the facts stated in it ar tme to the best of my knowledge and belief.
Signature of natural person signing above
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