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HomeMy WebLinkAboutBuilding Permit Application (2)li��i+3eisla f7� C{ M U LA j�jS L��R USC �7 �0N L EN' l�-G�l',Y PNj\ FOR 9Viq Not Name: Address: City: State. Zip: Phone- nrE somPLE vgnE me wm- ._„_, Hot applicable Name: _ Address: City: Zip: Phone: pgan7sAgE C©PVgFAPn Not AppiiCable Name, F Address: State: City: zip: Phone. SOMM, COMP M., -Not Applicable Nape. City: Zip: Phone: 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 theiclavnV rmit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or anenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and resew your dead 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 looms and accessory uses to another non-residential use WARNONG TO OWNER: Youp failure to nec@?d,2 ft&e of C@mmencamsn2 may veomit in your paVft twirga 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 recording your Notice of Commencement. gnature of Owner/ Lessee/Agent STl���lT`'��ER OOq G�[�dC�6"3i&DA The forgoing instrument was' knowrledged before me this day of "' ) , - 20 1-Z�,Y X r� C -1-J l--) i1 (Name o arson acknowledging) �S1 nature of Notary Public State of Florida Personally Known _L;::�'OR produced Identification Type of Identification Slghatufe of Contractor/License Holder STATE OF FLORIDA coupffy OF The forgfing instrument was cknowledged before me this df day of 20 L�Z by C---, L113 ` i r-> Yw (dame of pen6n acknowledging) /AJ (Signature of Notary Public- State of Florida Personally Known AOR Produced Identification Bpe of Identification Produced_-__ _ WKE MARTIN Commission No. I 4t*vllft - State of Rodrmmission No. •E COWIslon # FF 2i69511184. Revised 07/15/2014 (jag Pdit MARTIN of Flora ComrwissloM � iF I#6f51 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS