HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATIONTO BE ACCEPTED
Date; Permit
Building Permit Application MAR
2 012017
Planning find• a ++ - w r
Rulh.flng and code Regulation DivisiOn St. Lucie County, FL
ii Virginia Avenue,FortPierce Fl.34"2
' s - e commercial Residential
PERMIT APPLICATION• FOR: To Select.from dropbox, click arrow at the ond of line
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Fill in fog simple Title Holder i t l ,
Mora the Owner listeO 0ov@) State or Coynty License: (21Jq=62Qi2d t
If Volue of C�nstruitlo'n .Q • ♦, / }
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I ESi�NI? /IrNGIN I;R: 'P46t Applicable M( ;AG6 COMPANY: Not Applicable
Name: Name:
Address: Address:
City: Stat; City: State:
Zip: "r-�-- Phone: . Zip: Ph'Q-na:
FEE SIMPLE TITLE HOLDEN. Nat Applicable BONDING C+DMPAIVY: Not Applicable
Nage: Name:
Address: Address: .
City: City: .
Zip: Pliorte: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
st.Lucle County makes no representation that is granting a permit will authorize the permit holder to build the subjeet structure
which is in conflict with any applicable Haeme Qwners Assoaiatiptl rules,bylaws or an coVenatits that may restrict or prohibit such
structure.Please consult with your Mame Owner9 Asspglation and review your deed for any restricti6ns which may apply.
In consideration of the granting of this requested permit,t do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida,Building Godes and St.Lucie County Amendments.
The following Wilding permit applications are exempt from undergoing a full concurrency review;room additions,
accessory StruStures,swimming pools,,fence$,walls,signs,screen rooms and accessory uses to another non-resi¢gptial use
WARNING TO OVIWW: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
i gfore the first Inspection.if you intend to obtain financing,consult with lender or an attorney before
commencing work gr recording our Notice of Commencement.
5lgnature Aw esseq Gomtractpr as Agent fpr 0�6e_r Slgnetur f Conte or Licen§e Hold;r'
$TATE OF FLORIDA ST TE OF FLORIDA
COUNTY OF., �� 4_g '(�M � � COUNTY OF � ,�L�� 0
The for�Qing instrument was acknowledged before me The for ,ing instrument was acknowledged before me
this Azf stay of i'V1Q, t' 20( by this ay of �J 1 .r 20 j7,by
(N2of person acknawiedgin (Nam of person acknowledgi )
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of Neta Photic-5fi.to of*(�gqY Signature of Notary Publlo-Sia a of Fl rids
Personally o n g ors duced Ident(ficatiQn Personalty K,npwn .---R'[3i Produced Identification" ,-
Type of Ida is ioA►, ro.u Type of Identif!cat" produced
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tommissio �'� ' == Nfliar Public-S(fti*Florida Comm IQl7 Ruz au(Seal)
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Revised 07f 15/2014 .,,s,�;�ti,•r My comm.ExpiMS Fad 7;2026
REVIEWS FRONT ZANING SUPERVISOR PLANS VEGETATION SFA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
ATE
COMPLETE
INITIALS