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Home My WebLink AboutAPPLICATIONAllAPPLICABLINFOMUSTBECOMPLETEDFORAPPLICATIONTOBEACCEPTEDDate:___________________PermitNumber:PlanningandDevelopmentServicesBuildingandCodeRegulationDivision2300VirginiaAvenue,FortPierceFL34982BuildingPermitApplications1-—COUNTYFL0RI0ASPhone:(772)462-1553Fax:(772)462-1578CommercialResidentialXPERMITTYPE:PROPOSEDIMPROVEMENTLOCATION:Address:5008HICKORYDRIVEFORTPIERCEFL34982PropertyTaxlD#:3go(0o&caDirco-oLotNo.12SitePlanName:BlockNo.46ProjectName:.;‘r’DETAILEDDESCRIPTIONOFWORK:REPLACE6-NONIMPACTWINDOWS/I&.*idCoresfttdle/penu1-CONSTRUCTIONINFORMATION:Additionalworktobeperformedunderthispermit—checkallthatapply:‘ikt4f2flt5/j—GasTank—GasPiping—ShuttersWindowsfDoorsQ..%(Electric—Plumbing—Sprinklers—Generator—RoofPitchTotalSq.Ftofconstruction:Sq.Ft.ofFirstFloor:.-Co..CostofConstruction:$Ic’-DDUtilities:—Sewer—SepticBuildingHeight:[OWNER/LESSEE:CONTRACTOR:NameJUDITHGRIGGName:_________________________________Address:5008_HICKORY_DRIVEcompany:______________________________________•City:FORTPIERCEState:—Address:__________________________________________ZipCode:34982Fax:_____________________city:State:PhoneNo.6183106233Zipcode:Fax:E-Mail:W3flS°ipI@9fthOO(flmPhoneNo______________________FillinfeesimpleTitleHolderonnextpage(ifdifferentE-Mail____________________________________________fromtheOwnerlistedabove)StateorCountyLicense_____________________________Ifvalueofconstructionis$2500ormore,aRECORDEDNoticeofcommencementisrequired.IfvalueofHVACis$7,500ormore,aRECORDEDNoticeofCommencementisrequired. DESIGNER/ENGINEER:—NotApplicableMORTGAGECOMPANY:—NotApplicableName:_____________________________________Name:______________________________________Address:____________________________________Address:City:State:City:Zip:Phone_______________________Zip:Phone:__________________________FEESIMPLETITLEHOLDER:—NotApplicableBONDINGCOMPANY:ApplicableName:_______________________________________Name:_________________________________________Address:________________________________________Address:City:_____________________________________________City:______________________________________________Zip:Phone:_________________________Zip:Phone:____________________________OWNER/CONTRACTORAFFIDVIT:Applicationisherebymadetoobtainapermittodotheworkandinstallationasindicated.Icertifythatnoworkorinstallationhascommencedpriortotheissuanceofapermit.St.LucieCountymakesnorepresentationthatisgrantingapermitwillauthorizethepermitholdertobuildthesubjectstructurewhichisinconflictwithanyapplicableHomeOwnersAssociationrules,bylawsorandcovenantsthatmayrestrictorprohibitsuchstructure.PleaseconsultwithyourHomeOwnersAssociationandreviewyourdeedforanyrestrictionswhichmayapply.Inconsiderationofthegrantingofthisrequestedpermit,IdoherebyagreethatIwill,inallrespects,performtheworkinaccordancewiththeapprovedplans,theFloridaBuildingCodesandSt.LucieCountyAmendments.Thefollowingbuildingpermitapplicationsareexemptfromundergoingafullconcurrencyreview:roomadditions,accessorystructures,swimmingpools,fences,walls,signs,screenroomsandaccessoryusestoanothernon-residentialuseNameofpersonmakingstatement.PersonallyKnownORProducedIdentificationTypeofIdentificjtionProduced___________________________,aV/L(SlnaTy%fNotaryPublic-’a)OFFICIALSEALSJBRASWELLCommissionNo.____________45PUBLIC-STATEOFMYCOMMISSIONEXPIRESflWa-SUPPLEMENTALCONSTRUCTIONLIENLAWINFORMATION:POSTEDONTHEJOBSITEBEFOREThEFIRSTWITHYOURLENDERORANAHORNEYBEFORE“WARNINGTOOWNER:YOURFAILURETORECORDANOTICEOFCOMMENCEMENTMAYRESULTINYOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY.ANOTICEOFCOMMENCEMENTMUSTSERECORDEDAND)wner/Lessee10STATEOFFLORIDACOUNTYOFINSPECTION.IFYOUINTENDTOOBTAINFINANCING,CONSULTRECORDINGYOURNOTICEOFCOMMENCEMENT.”entforOwnerTheforgoinginstruentasacknowledgedbeforemethisdayof,‘Vt2Y7_,202bySignatureofContractor/LicenseHolderSTATEOFFLORIDACOUNTYOFthis..dayofTheforgoinginstrumentwasacknowledgedbeforeme20byNameofpersonmakingstatement.PersonallyKnownORProducedIdentificationTypeofIdentificationProduced______________________________—(SignatreofNotaryPublic-StateofFloridaLlPg11iionNo._____________(Seal)k’O2!22REVIEWSFRONTZONINGSUPERVISORPLANSVEGETATIONSEATURTLEMANGROVE•COUNTERREVIEWREVIEWREVIEWREVIEWREVIEWREVIEWDATERECEIVEDDATEICOMPLETED1ev.2/1/19