HomeMy WebLinkAboutBuilding Permit Application DESIGNERf ENGINEER: "Not Applicable MORTGAGE COMPANY: `Nat Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
1 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 parmit,I do hereby agree that 1 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
beforl the first inspection. If you intend to obtain financing, consult with lender or an attorney before
corrinhencing work or recording our Notice of Commencement.
S
ignature of Owner/Lessee/Agent ature of Contractor/License Holder
STATE OF FLORIDA , STATE OF FLORIDA
COUNTY OF �&sr�N 1 4111 E-�' COUNTY OF Im ton ' k
The for Ding instrument was acknowledged b fore me The forgoing instrument was acknowledged before me
this day of Nv s>;V- 20y this day of20 by
( ame of person acknowledging) (Name of person acknowledging)
{Signature of Notary ublic-State of Florida) (Signatur of Nota ublZOR
ic- ate of Florida)
Personally Known OR Produced Identification Personally Known Produced Identification
Type of Identification Produced %I U?V )j(,V\&Z_ Type of identification Produced
Commission No. r,) 0 k".10 (Seal) Commission No.GATSIN FEDE _ , A AOUNG
.
�atpRY,gss ., * MY COMMISSION#FF 951069
Q NOTARY PuRLIr
i a STATE OF FLORIDA 9rFQ ��o�> sandoathr4audootNotary samcos
Revised 07/15/2014 :. }Comm#GG066420
INCE 1Fynirtwk 1119r,11)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS