HomeMy WebLinkAboutBuilding Permit ApplicationAL APPI ICABLE INFO MUST BE COMF `ED FOR APPLICATION TO
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Building Permit APPlicati®nL
RECEIVED
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23W VftbfaAvenue, Fort Pierce FL 34918Y .r
Phone %462-1553 Fax cie t;QWP , Pn+rr
(�t)4sz-157e Commercial Residen
PERMITAPPLICATION FOR To Select from d
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Lot No. 7,
Block No.
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WVAC. ✓Gas Tank —7 x/Gas Piping — Shutters
—Windows/Doors
—1:fectric —Plumbing —Sprinklers
—Generator _Roof ® Noogpbh
Total S0. Ft of Construction: =
Sq. Ft. of First Floor ,
Cost of construction: $ — /_ YSO G
Utirdies: —Sewer —Septic Building Height
ZIP CoOe:_Mq0 fax - - --
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State or County License: O a;Ce? N
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DESIGNER/ENGINEERc _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: • State: City: State:
Zip: Phone: ZIP: Phone:
FEE SIMPLE TITLE FrOLDER: _ Not Applicable.
BONDING COMPANY: Applicable
Name:
_Not
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.
(.certify that no work or installation; has commenced prior to the Issuance of a permit
St Lude Coun�y.makes no representation that Is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an9covenants 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 buildingpermit 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.
ESignatu[Si naty re e,, -on ra ar/License H er
STATE OF FLORIDA STATE OF FLORID/
COUNTY OF �� r COUNTYOF �\. LLNkE
The f�oing instr ment was acknowledgeyl�before me The f oing instru ent sac owledge before me
this dayof
20 by this'�daycf��20Pby
i
�kki
(Name of person acknowledging) (Name of person acknowledging)
��Q� 2/y
(Signature of Notary Publi State of Florida) (Signature of Note Public-._ tate of Florida)
Personally Known _ X OR Produced Identificat' ersonally Known \:. OR Produced Identification
Type ofldeMricationProd e or identification Prod
CY�V 04 ryy� anTTl"[i�—^
Commission NO '_State of Florida -Notary Publ c �,,l ropy gij
C(S i ssion N GG 190282 mmission No °i's stat orida-Notary Public
N GG 190282
My Commission Expires _ �: Co�ion
M Commission Expires
February 26, 2022 'sy �p y
'!i
r I'll"" February 26. 2022
REVIEWS FRONT ZONING SUPERVISOR PLANS -VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW. REVIEW- REVIEW REVIEW
DATE,
RECEIVED
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c
DATE
COMPLETED
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