HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APIPILIC4110W TO BE 4CCEPTED
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Building Permit Application
Planning and Development 5ervice5 MAY 30 2017
Building r r ■r- Regulation • s
2300 Virginia Avenue, . FL '
ResidentialPhone;(772)462-1553 Fax:(772)462-1578 Commercial
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DESIGNER/ENGINEER: _Not Applicable IVIORTCsAGE 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__._. _
: Phone: .
' - -- 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 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 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 5t. Lucie county Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory stf uctures,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 fbr
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 recordWg Your Notice of Commencement.
S
5ignatu ner/Le ee/Agent Signa ont ctor/License Holder
STA � ORIDA ST OF FLORIDA
COUNTY OF LLC%,e. • •; COUNTY OF Luc 1 e
The forgoing Instrurnent was acknowledged before me The forgoing Instrument was acknowledged before me
this 21day of -7-7'by this�tP day of M ab.( ,20 11 �by
Le GYDssrr"n '_kwossn�ap,�,
(Name of-person ac nowledging) (Name of person cknowledging)
gj�t�- rv�� e,4��-' C�P-4"_tj.�atk
(Signature of Notary Publlc-State of Florida) (Signature of Notary Public-State of Florida)P
Personally Known Y OR Produced Identification Personally Known Y OR Produced Identification_
Type of Identification Produced Type of Identification Produced
Commission No._AF0 Commission No.PFQ09aaD, Mr^^ ea
K ISTINA L LOUDER CI;
KRISTINAaQi'”Vit+
i.LOUDERB CK `"1 MY COMMISSION
SION MY COMMIS,
2<°
9222 4,ocp, EXPIRES August 7,
�,,�w EXPIRES August 7.2ay7 27
Revised 07/15/2014 "w ,,^ (4V71369-0153 Fror Mora s�toext
(4 3906153 FfondallotarySarvica.com
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS