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HomeMy WebLinkAboutBenett - 5049 N A1A#205 - SLCALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 5 b 9 1ai) d fl Permit Number: S 1� 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 V--� PERMIT APPLICATION FOR: �� rn, . _ �` � 1� PROPOSED IMPROVEMENT LOCATION: Address: pZt} C.� �— I wc, 3 j 1 Legal Description: C!)co-bi4�e,ZA� �T1 �re_L j SUPPLEMENTAL CONSTRUCTIO LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State'. Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: Address: City. Zip. Phone: City: 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 Count 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 jobsite before the first in ction. If you intend to obtain financing, consult with I der or an attorney before commencing first your Notice of Commencement. XSn re of owner/ Lessee/Contractor as Agent for Owner ure of Contractor/License Holder STATE OF FLORID COUNTY OF STATE OF FLORIDA `` ` COUNTY OF (� � -�-L c The fcy ing instru as acknowledged before me this dd�5 day of O Zpd,©by The fo i g instru a was acknow ed before me this Ji ZO -20by J Name of person makingstate ent Name of person making statemen _Personal) K� OR Produced Identification wn OR Produced Identification Type of Identification Type of Identification Produced Produced ■ I 4 A L � �911Nilif4ll {signature of Notary Public- State of Florida �a�`'jA>NZ ( Mature of Notary Public- State of Florida) . `' ,.o�sioy' ci, Commission No. { ; . � R1lARY �o• mission No. d+- SAHRINA L. BLACK ;*GM862r�'NA * C. Ht i : : �G o' Q o 289862 REVIEWS FRONT ZONING ,Ael tic Undg •i +5fi]�Rp �� ���` F,.?AiVS VEGETATION SEA TURTLE •• o6�aed EhN ��et `�Q'61� s '• COUNTER REVIEW t''EVIEW REVIEW REVIEW roEF� DATE trill RECEIVED DATE COMPLETED Rev. 8/2/Z7