HomeMy WebLinkAboutschmidt infill permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
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Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
Residential /ft�
PERMIT APPLICATION FOR:
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Lot No.
Site Plan Name: 4dt (` [
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Block No.
Project Name:
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SUPPLEMENTA4C0
DESIGNER/ENGINEER:
Name:_
Address:
NSTRUCTION LIEN LAW INFORMATION:
Not Applicab
City: State:
Zip. Phone
FEE SIMPLE TITLE HOLDER: T Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
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 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
rnmmPnrinF wnrk nr recnrdine your Notice of Commencement—
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/Lice a Holder
STATE OF FLORIDA
OF f7-'� LLi, 6 ,c-
STATE OF FLORIDA
COUNTY OF
COUNTY
The forgoing instru e t was acknowledged before me
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The forgoing instrument was acknowledged before me
this I ► a,' 20�41 by
this __(_, day of
(Name of person acknowled g)
(Name of person acknowle ng)
(Signature of NotaryA4ublic-State of Florida }
{Signature of NotaryOublic-State of Florida }
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Idyatification 1, �a
Type of Identification
Produced VI'K i,
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 7/2014