HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATIONTO BE ACCEPTED
wox? Permit Number: 2,03 C 2, (9 (A 2,
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FEB 224' 6 2020
Building Perj • y
Planning , DevelopmentL.Pnf-y, Perml]tting
Building and Code Regulation Division
0: Virginia Avenue,Fort-Pierce FL 34982
Phone: . t Commercial Residential
PERMIT
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Name
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Address: f f�_ ai.z! ,!' t t. .mss/ i s . +■; !
City: tli State-
Zip Code: Fax: City: -State:
Phone No. Zip tt -
Phone
Fill in fee simple Title Holder on next page if different E-Mail �Mke-tp ,. I sr +.0 . r f 11
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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 County makes no representation that is granting a permit will authorize thepermitholder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or an covenants that may restrict or prohibit such
structure.Please consult with your Horne 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
commencing work or recording our Notice of Commencement.
Sign trewner/ a Con s Agent for Owner Signature of C ractor/License Holder
STATFLORIDASTATE OF� COUNTYOF
OR9DCOUNTYCOUNTY OF ./f/[
The for oin instrumg t was acknowlecid before me The forg i instrum t w s acknowledged before me
thislay of 2 by this of 20,; 0 by
c,�n erg,lj P,ue
(Name of person acknowledging) (Name of person acknowled ing)
(Signature of Notary
• Public-State of Florida) (Signature of Notary Public-State of Florida}
Personally Known t� OR Produced Identification Personally Known L-"/ OR Produced Identification
Type of Identification Type of Identification
Produced INCH-A'I' SONNEVELDT Produced
Camn�sioo$0 338bc2 IIfG}1AQ 0'SOI tEVEiDT
Commission No. �� ".,E+ k ryZl 223 Commission No. . ^#GG 23
--r'��r'. 6irsa:5�.3�d9ec Ivry seri�n y � E�i�s February 27.2023
OF 6awTWW id�y¢c►lu�sario3s
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
K 7/2014
ev.