HomeMy WebLinkAboutBuilding Permit Application APPLICABLEALL f ♦ t L ' ♦ f t
Date: � •-
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Building Permit Application JUN 19 2017
Planning and Development
Building and Code Regulation Division St.Lucie C ty,FL
11 Wrvinia Avenue,Fort
Phone; d . d r w Commercial Residential
PLRMIT APPLICATIONFOR:
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Site Plan Name:
Block No.
Project Name-
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Setbacks Front Back: Right Side: Left Side:
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1 (DESIGNER ENGINEER: . Not Applicable MORTGAGE COMPANY: Not Applicable
r 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:
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 Cosies 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,wails,signs,screen rooms and accessory uses to another nonresidential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in yaur paying twice 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
commenCinp,work or record" our Notice of Commencement.
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_Signatu er/Le ee/Agent Signat ont actor License Holder
STA ORIDA ST OF FLORIDA
COUNTY OF LLk COUNTY OF I.IC I C
The forgoing Instrument was acknowledged before me The forgoing Instrument was acknowledged before me
this 19 day of 2D Eby this day of ,20 �`" _by
C i rossyna n n > s Sim ttir-,
(Name of person acknowledging) (Name of person cknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known / OR Produced Identification
Type of identification Produced Type of Identification Produced
Commission No.F 009
Co mission No.i=jb +w� ea ISTINA L LOUDE CK'
KRISTINA LLOUDER CK ;•i rnvcc�nnnnlsslon, 22,-
COMMIS59,� ' #FF ''tjoL,-��.,� EXPIRES August 7.2 .7
Revised 07115/2014 rya�a
EXPIRES August 7.2oi� ao7)8%_0193 eonaeuvo��s
arvioo.«
( 398 4159 FlorFdetsatary5ervkv.o0m
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS