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HomeMy WebLinkAboutNicholsPVApplAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ? - 1�01/ ` I Permit Number: �i COUNTY 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 PERMIT TYPE: saw� �, �.�er-y� PROPOSED IMPROVEMENT LOCATION: Address: &C)©'S -Go a�!, 1 Q ET PI G>'Ct, (.- 3 LJ 9 �-a _ Property Tax ID #: 3tl () � (hh(0 0 2cl 3 0005 Lot No. { Site Plan Name: t.Oc? t" 1V � C-� 1 S Block No. j I . 'N _- A k- -I r . SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGN EER: _ Not Applicable Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Name: Address: City: Zip: Phone: Not Applicable 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." JJ I.Tj- Signature of Owner/ Lessee n ractor as gent for Owner Signature of Cont r/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ST L u C I e ICOUNTYOF ST L u c k The forgoing instrument was acknowledged before me thisday of To I f 20,9A by Pdr�er4 ZrQ I l90-k Name of person making statement. Ily Kn-oWD OR Produced identification Produced (Signature of Notary ub)ic- Sta , volqx --id! �o public StHa of KimberlyLarge Commission No. oZ�e�liJ Commission GG 9 pr Hxpkss 12rM2023 REVIEWS I FRONT ZONING COUNTER REVIEW RECEIVED DATE COMPLETED The forgoing instrument was acknowledged before me this day off 20,A by Name of person making statement. ersonally Known OR Produced Identification Type o entification Produced e g ture of Notary Public- to all'%Za �No ry WStsteof (� Kim y large co ission N (�' 1� r-�commissionGG 9 res 1=612025 SUPERVISOR PLANS I VEGETATION I SEA TURTLE I MANGROVE REVIEW I REVIEW REVIEW REVIEW REVIEW