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HomeMy WebLinkAboutBuilding Permit Application 1 I 1 1 I 1 •t 1 � � �� � II IIS ALL APPLIl • MUST BE COMPLETED FOR APPLICATION / BE ACCEPTED Date: • •go� � � t ., i • 1 f • Planning and Der■ NOV 12017 Phone:Building and Code RegulationlIDIA51I 2300 Virginia Avenue,Fort Pierce FL 34982 P alptment PHIP • . Commercial • _ I. lt PERMIT " " • FOR: 4tc'1u'' >. 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WO1 .. NOV-01-2017 WED 07 56 AM CENTRAL SCHEDULING FAX No. 3212686138 P- 003/004 '•r � y ?•� .•d ..� .,;.^' ' z ,K:o , �,i' l^'r.t a. ^d.N� 4•v. 1 ,�� 1•• ^i/f r r- ��..i�. dra":�7. a`.�.�ti�.ro �r�rii5"v d'1''Fu,t .d S'�?•iP'' �' a Yl' :$. 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 Counter makes no representation that is granting aHAermit will authorize the permit holder to build the subject str pture which is in conflict with any applicable Homeowners Associatlon rules,bylaws or and covenants that may restrict or prohlblt 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,l do hereby agree that I will,in all respects,perform the work In accordance with the approved plans,the Florida Building Cades 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 commend work or recording our Notice of Commencement. Signaturef O ner/Lessee/Contractor as Agent for Owner Signature of Co ractor/License Molder STATE OP FLORIDA` [ + C.� sTATE OFORiDA � �` COUNTY OF �1- `/�`\ 4� The forgoing instri4ment was acknowledged before me The forgoing instru ent was acknowledged before me this day of ? 20_by this_�_day of V Mf 20AI by iia e'01 f-p- P'pber� Name of per n making statement Name of perso making statement Personally Known OR Produced identification Personally Known OR Produced Identification Type of Identification Type of identification Produced Produced (Signature of Notary Pub -Sta aF,lor (Signature of Notary Public-St �,, orida} ��t�hertna Konger ;;r"•s. Catherine Konge>r C onflFl=172372 �;�= 100I'F17Z37 Commission N Commission No. °C� OGT 2B, • = ZB,2018 # Expires: 2018 THRU , HONDSdTHRU �'• •"�� ImPW1IDANOTAA%LLC N� •`� 15T$BONDED OTARiGLI,C REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/7/17 I•