HomeMy WebLinkAboutBuilding Permit Application ALL APPLI.CP�,��IE INFO MUST BE COMPLETED FOR APPLICATION To B
Date: 71 n-;45t. E ACCEPTED
Permit Number: j:Sjzz_j
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Planning . . ! Services git Application
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Holder on next page(if different
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if i'isted above) State Qr County License:
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bESI£NEitjE GINEEIt: Not Applicable iMURTGAGE COMPANY: Not Applicable
Name. Name:
Address: �; Address:
City: State, City: State
Zip: Phone; Zipr Phone:
EEE SIMPLE LE HOLIER: ___.Not Applicable BONDING COMPANY: __M__Not Applicable
Name: Name:
-Address: Address,
City; �,. city;
Zip; i Phone Zip:_ Phone:
I certify that n :ork or installation has commenced prior to the Issuance of a permit,
St.Lucie Count `akes no represertCation that is granting a permit will authorize the permit holder to build the subject'structure
which Is in can with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Pleas 1 onsult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration f the;granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
In accordance w the approved plans,the Florida Building Codes and St,Lucie County Amendments.
The following b ' ing permit applications are exempt from undergoing a full concurrency review:room addItlons,
accessory strut es,swimming pools,fences,wails,signs,screen rooms and accessory uses to another non-residential use
WARNING T I" WNER:Your failure to Record a Notice of Commencement may result In your paying twice for
im rovemen to your property.A Notice of Commence ertt must be recorded and posted on the jobsite
be a the fi : inspection. If you 'ntend to obtain financi ,consult wlt Fender or an a torney before
corn encin dinRv -Not Notice of Comment . ent.
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Signat re of s ee Sig ure o co tra ce se Held
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STAT' OF F IDA (� t ST E OFOF ORIDA� *-
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The forgoing in r. ent was acknowledged before me The forgoing Instr�s-acknowledged re me
this2,q day o 20. by this qday of 20 b
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Nature of per o knowfedgi g) {Name of pe acknowledging)
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Signature of l ry Public-State of Florida) { ature of Notary P lit-State of Florida)
Personally Kna i i ti Personally Known =AOR Produced identification z
Type of ide Stift 'tI..n Produce Type of Identification Produced„
f a stat,�� �orida Commission No. {Seal}
cornmissioA jta�i o
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xp es 12 .2017
Commission#FF 43$392
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Revised 07J i12014
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