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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 concurrent review: room additions,
accessary 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney commencing work or recording jqq[_N���12cement.
yt
Signature .fOwner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this k day of 202, -by
Name of person making statement. ------
KAREN D'ONOFRIO
Personally Known OR Produced identification '.1y CCIMMiSSION # GG 237558
Typ7eof I entification Produced A*EXPIRES: August 5,2022
,ru Notpro Put6c Underwriters
{Signature of Notary Public- State of Flori
KAREN
Commission No, MYCOMMISS!, oe_
Bonded Thru -------
. . . . . ....... . .... . ...... ....
REVIEWS FRONT ZONING SUPERVISOR PLANS 1 VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW i REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5[/_0/i'1
Appointment Date: Time: \
Doors & More
Treasure Coast Garage Door Specialist
Name
Address (3
Doors & More of the Treasure Coast, Inc.
9 ��5 837 S. King's Highway
Fort Pierce, FL 34945
(772) 409-4501
www.doorsandmoretc.com
GARAGE DOO QUOT sak &�
/;;Ali %0 _ n-,- 1 37.2-?S
,1 Street i City '
Phone `J��Z " - _7,� 7 9 E-mail _ fJ 10, G CC d J P P106j;nJ, Com
Door Size 1(0 X Windload L Finis Flush BeadBoard Horizontal
Color: White Almond Brown Oak Cherry $ �% 10. `
Trim: Aleo
es No $ & C —
(E:0:Ut)
C,
$ �D t
Insulation Alt $
s $
Operator �� $
Remotes: .1-2. 3 Rail�7 8 Ft
Keypad —Yes -- --M $
Additional Notes: 404 no
i
eP
Permit
Total
SO%
Deposit
Balance due at installation
Accepted by Customer ' Date
/ Signature
$ .g,119
$ ae,2D,1'1�
$ 33vs, ---9
$ I Cp-7a, E0
$ (a 7 ,�_ t !�O