HomeMy WebLinkAboutBuilding Permit Application'
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If value of constructionig $2500:br more, a RECORDED Notice of Commencement is required.
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Address: 1179012-42k.
city: State:r
Phone No.
Zip Code:
Fill in fee simple Titllff":Aolde r'on next page (if different
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from the Owner listed above
State or County License:
If value of constructionig $2500:br more, a RECORDED Notice of Commencement is required.
NSTRUICT,11"ON N LAW "T
SUPPLEMENTAL ME RMATl,0,N,:41,.
19
DESIGNER/ENGINEER:`T _&,eftt Applicable
MORTGAGE COMPANY:' Not Applicable
Name:
Name:
Address:.
Address:
City: State:
Zip: Phone,.
City: State ,.��'
.Zip: P, h 01 r -Z'- "!'j;
FEE SIMPLE TITLE DE R", 4�Kot Applicable
BONDING COMPANY: 4,No Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:,,
Zip: Pho'ne:
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REVIEW
I certify that no work or, installation has commenced prior to the issuance of a permit.
St. Lucie County makesnorepresentation that is granting a permit will authorize theermit holder to build the subject structure
which is in conflict ith!an applicable plicable Home Owners Association rules, bylaws or an9covendnt§ that may restrict or prohibit such
structure. Please consult:` ith y� U' r Home Owners Association and review your deed for any restrictions which may apply.
ll:In consideration of the r'nti cifthis requested permit, lAo hereby agree that I will, in all respects, perform the work
in accordance with e:, ro e plans, the Florida Building Codes and St. Lucie County Amendments.
The following build ri it a, 1 lications are exempt from undergoing a full concurrency review: room additions,
accessory structures, s" in ',Ppols, fences, walls, signs, screen rooms and accessory uses to another non-residential use
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WARNING TO OWNER: Yout failure to Record a Notice of Commencement may result in your paying twice for
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building p�g M
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improvements to �Jdr L'-'�--opelrty. A Notice of Commencement must be recorded,,and posted on the jobsite
before the first insp,e6tion.If you intend to obtain financing, consult with lenderlor an attorney before
commencing work ,,d',recoeding your Notice of Commencement.
Signature T-6. ner/[U;
STATE IDA
COU
e foras. n,
ing instrumFn!�N
this _ day of
(Name -6f pe
/'� /\ v
(Signature of Notary 71,11,
Personally Known
Type of Identification _Pi
Commission No. -F I
Revised 07/15/2014-,
edged before me
20 I-1by
- StatLi of Florida
OR Prbducecl Identification
Sign re of
Cor/License Halder
ZE OF L r
ATE , _�����d �1�--'
Thelofgoing instrurtierilt was ack OWIE!dgqo before me
thi_ by
(Name of person acknowledging)
(Signature of NMary Public- State of Florida )
Notary Public - State of Florida
I
Commission # FF 234(,Wal)
My Comm. Expires May 27, 2019
Bonded thlough National Notary Assn.
(Seal)
ARM Mede POO
NOTARY PUBLIC
STATE OF FLORIDA
Comm# FF972407
FvNrm V117J2020
Sign re of
Cor/License Halder
ZE OF L r
ATE , _�����d �1�--'
Thelofgoing instrurtierilt was ack OWIE!dgqo before me
thi_ by
(Name of person acknowledging)
(Signature of NMary Public- State of Florida )
Notary Public - State of Florida
I
Commission # FF 234(,Wal)
My Comm. Expires May 27, 2019
Bonded thlough National Notary Assn.
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