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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONF'• L_ O LL L E} R• . r • All _. �... ;.. ....; �.7... .. .. .... ...._.._.........y..-.,...........irli'�ia:!!ofT1�J1'.'A'L...!_. ::St'ii+`tlT7;:-.",'.-'.x,Xr i:•ai;{yy��4'ii5.lvi'S Ki_ti�m:ii;i!".ijF,id.:':�';S_".:z .ate-�-"L_.l .d!�y��Fl plol • • I - • , / w r • I �u: ,. �.,� :,--g,. "';;.,. ;�.;;. ., .. r..u• c. ,..... rv•, .�:.,i yq ::ry. �j �Ti�`'`!�!i.31 ,t _ tv�'f...' I. ,{i:1;'S.�(:'f�Ti�''''} I. > /4j:J! (t.'�id T[t.,q. tti�}1.2:1fi D D -. D ...� 'r.� �'i.,a,rp xf +!(nf. �x s I�it f.,f I`i!' n' ,f t t It �.,t5�i''tt�` i„(tpT!��t�2,!��m�i.��>y�"-'.'iit I!' t •1 s+ W f �::! f. .. .1'x.i:'!44y:. .:vl:d �.-h F,tin\!!•!ails:'r..eY.I:�..,.:....,fi,d:'±l,i.f... :ILx .v1 !!T !i{➢1 {�:......',� dLi{.� i'_;__:i iv: 4i11 '1%.i(ni!.. I:�I_k,Y�� .�!; n!,�',m;; q:!:v #:i'Nu - .:k;p ..a'a ,!:1!,ry �,>--=ii-f. 'Li,,,';7e:..•ly_��..t•;l:r; �+ a� i':, L:: N�nu 1 ii .... ._. .. ..-n•,l. i © c,!Ysly a. l'' :iliSv` .P .i=f' i':l�!�'.f=''_""b°:'°. et if 1Se'i K �1g1 tut t �"-trv'tl>•x� , ! - u!, fitYi�:'i.5:3iif{T i' 0',''!t�} 4 ilw�:+a•� n s li!.yt il!f�-y§'� 1�PM r'�'�! 54 .. . , I code: Phone No. • I I Fill fee Title .. . . DESIGNE ENGINEER:, r _ Not Applicable MORTGAGE COMPANY: `'Not Applicable Name: ��'JIi/�cJ��' /.cJ� Name: ..';,Not Address: 4Z_.19-iy4 Address: City:V,Pro,61&.of, r• 6-. State:[_ City: State: Zip: ? Phoneme 4 - /''1aC-.z Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable Address: City: Zip: Phone: Address: 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 thepermitholder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or an 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 commencing work or recordin our Notice of Commencement.. Signature of Owner/ Agent/ Lessee/Contractor Signature of Con ractor/License Holder STATE OF FLORIDA n/ STATE OF FLORIDAC % /_ COUNTY OF 1�f l/J e i COUNTY OF �L/J �J The for oing instrument was acknowledge before me by The for ing instrum nt was a knowiedged efore me day My thi day of #.t J 2q this of / (Nam of person ac wledging) (NalpiaTf person acknowledging ) (Si nature of N a ublic-State of Florida) ignature of tary P lic- State of Florida ) Personally Known Lto OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced _a+rneo sHERRIFEHLMPN _Ow Produced r� ' • ° comngsstcn# GG 167 60 �oRr° arc SHERRI EEHLMAN Commission,No. • ) EarplresMefch14,20 2tommisslon No. . Cor(5696 #GG187160 .. Evhs March 14, 2022 �OF PIMP eOIdCCTEI11Budpe(npWYs�'rx9 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE II • COMPLETED �1 �h Rev. 7/2014