HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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 _X_
PERMIT TYPE:
PrROPOSED IMPROVEMENT LOCATION:
Address: It 02- SCIenU PhNW, ege51g 2-16 Q
Property Tax ID#: 34cx ) , "��1 ` r2� Lot No. 2-23
Site Plan Name: Block No.
Project Name:1 _Ntf.4 W Qn
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N OF WORK .'1:
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:
I
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 YOUR PAYING
TWICE FOR IMPRO E NTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON TH E BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LE TTORNEY BEFORE RECORDING Y9VR NOTICE OF COMMENCEMENT."
Signature of 9 / essee/Contractor as Agent for Owner Sign ure o ontractor/License Holder
I
STATE OF FL RIDA STATE OF FLO�J, A
COUNTY OF�i C* �a��a P. COUNTY OF Cm
The forgoing instr ment was acknowledged before me The for5oing instrument was acknowledged before me
this'd day of. 202 by this 27 day of -e 2012 by
Name of pe on nidking statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification „
Produced DA,-) l:'.0 Produced�Q rIVQJ�6 r1C�ll�e
Ovi-
(SigrjAiEfre of Notar pHENSON (Sign t re of Notar
°''. TEPHENSON
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MY COMM�� 9 GG 268231 ;...ugh;• MY COMM GG 268237
Commission No. '*: *- p��8:1� 16,2022 Commission No. *: :*?
EXPIRES -16,2022.
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE i
RECEIVED
DATE
COMPLETED
Rev.