HomeMy WebLinkAboutBuilding Permit App 2203-0455 C. Hunsberger-- All APPLICABLVNFO MUSTBECO0\PLBEDFOR APPLICATION TDBEACCEPTED
7-7 Permit Number: 2!�P
Date:
Building Permit Application
Planning and Development 5crvices
Building and Code RegulotiooDivision
23D0VirgNiGAvenue, Fort Pierce Fl34982
Phone: (772)46I'1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
Address
[OnOnAerCiJ\ Residential
[B[)G Funding _________
Property Tax |D#: I Block No. _--___-
Site Plan Name:
Project Name:
=~,^' �ncondElectrical KXete (Affidavit required)
Additional work tobeperformed underthispennit-checkaUthatapply:
Pond
-Mechanical GasTuok —Gas Piping _Shut�cs —Windows/Doors
Root
pitch
Electric _-Plumbing __Sprinklers _-Generator -
-� �q�Ft�ofFirscHoor
Tota|Sq Ft of Construction:
-- mo v Utilities: —Sewer wer _Septic Building Height:
Cost of Construction: $ 5000,
I.
Phone No.
W1aU
Fill infee simple Titie Holder on next page `' different
from the owner listed above)
Zip Code: Fax�
State or County License
Commencement is required.
if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
Name:
Address:
Citv:
Zip: Phone
- Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
rity
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 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 attorne before commencing work or recording our Notice of Commencement.
Signa ure of Contractor - or - Owner Builder as applicable
STATE OF FLORIDA
j COUNTY OF LI Cl8
Sworn to (or affirmed) and subscribed before me of v Physical Presence or Online Notarization
this day of IM(?k,11 XY1 , 202.by
i
Name of person making statement.
Personally Known OR Produced Identification 4—
Type of identification Produced tO
l
{ (Signatu o otary Public- State of Florida)
i Commission No.Arli_nseal) '� JUUE&MEDECKE
WCoWl3SloNm33 u
:AupwtlQ,2023
Notuy P�d�go tM�tennhw�
REVIEWS (
FRONT I
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
l
_RECEIVED
DATE
COMPLETED
I
Rev 10/12/21