HomeMy WebLinkAboutBuilding Permit Application-h -h
= A
O
A w
c
V0 0'
o �.
O N
O LnN
0 0
0
O
� 3
M
o
v rrn
M n
v
za
D
m
m D
z
h
o at el
3
3 O
ro �
�M
3 n
r+ �
3
(D(D
Q.
E.
rt
m
m
V
N
n
0o
Q
w
�'�0
I
Z
O
�
(D
V
�
0
3
lj
cv
�•
�,
= oar
n
m
(D
Z
M
''
N
z
�V\�
N
co
rn
tD
Q
CO
O
o
Lj
fn
z
'1
A
dl f0
4 C
OD
z
N
rp
kn
fD•
'�•OD
Lrl r�
C4
cn
co
z
O
O
Lrj T
W o
Q r0
p
W
m
Y
;I,
-
z
m
X
=
rr,
M
@
,
co
z
m
CA
m
z
m
O
p
r-
o
co
r
O
cr
0
:3
D
m
<
(D
W
O
r
O
Lrl
D
�
n
000
x
=
'n
r
V
�•
W
O
0
V
3
lL
n
ro
m
CL
r+
r
D
m
.a
N
r
rt
r+
rD
O�
rt
m
v
_N n
D
CL
n
0o
z
-I
�'�0
I
Z
O
�
(D
V
�
0
cIn
lj
cv
O
= oar
-v
M
N
�V\�
N
c)
Q
....
O
Cl\l
z
'1
A
dl f0
4 C
m
Nrb
rp
•
Lrl r�
to
y
m
to
O
O
O
n
0
n -4
0 0
o,v
v,
—h
o -n
O
-h
n
� O
O rt
M �
O 0
O �
O
ofN
O
0
1
0
f'1
-n
E
3
a
Oq
Ln
_0.0
m
N
A
O
0
0
h
D
CL
I CL
o
n �
3
o
n• �
N �
1+
O
cr
cn
O
G� 3
Q
Q
m
G) 3
Lrt
� I
�• n
rD
UU �
Sy
r+
cu
r+
C
(D
F.
m
CL
0
0
0
H
0
Ln
n
O
z
n
D
O
z
X
O
m
m
Cn
z
0
O
z
0
m
O
z
Cf)
D
r
r
z
Cm
O
—I
Cl)
m
O
z
.0
rD
z
lv
m
-n 0
a�
z -i
a)
N x
•P
Ln
0
N
in
O
w
w
0
O
0
r7
m
"D
s
fl
CL
;um
W
cIn
cv
O
= oar
-v
M
c)
Q
....
O
IL
z
A
dl f0
4 C
m
Nrb
rp
•
Lrl r�
to
y
m
to
O
O
Lrj T
W o
Q r0
W
m
;I,
-
X
rr,
n
z
rb
m
r-
o
r
O
y ua
4
:3
m
ko
N N
W
O
Lrl
D
Z
000
=
'n
r
�•
W
O
0
V
3
n
m
r+
D
.a
r
r+
rD
O�
Ix
r7
m
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
City: State:
Zip: Phone
Address:
City: State:
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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Sign ure of Owner/ Lessee/Contractor as Agent for Owner
ST TE OF FLORIDA
COUNTY OF_
The forgoing instrument was acknowledged before me
this 4� day of t 20_ by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Noilkaf
°" "
'� �LE KONRATH
Commission No.ABIG 0F)r # GG060206
,;P„ EXPIRES January 05, 2021
REVIEWSFRONT ZONING SUPERVISOR
DATE
COUNTER REVIEW REVIEW
RECEIVED
DATE
COMPLETED
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF `," 10L
The forgoing instrument was acknowledged before me
this 21-? day of /�'" 20 60by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of4dta `,Stae KONRAT
- H
Commission No. s ''';NY $)GG060206
. „ PI ES January 05, 2021
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW