HomeMy WebLinkAboutpermit applicationDESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: _ City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING C MPANY: _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 Counttflyy�makes no representation that is granting a permit will authorize the permit holder to build the subject structure
structurin e. Please consult any applicable
Owners Association
iandrreviewyyour deed for any restrictio s that which may arestrict or l. prohibit such
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 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 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 withlender or an attorney before
commencin work or recQrdingvour Notice of Commencement.
s
Sign re of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF_�� I t COUNTY OF
The f oing ins u nt y+as acknowledge fore me The forgoing instrument was acknowledged before me
this day of ; L V 20 thy this _ day of . 20 _ by
flee M- ,l -h Qcf)a.
(Name of person acknowledging) (Name of person acknowledging )
�hQ 0 �f1�-�ir�mDrn,a
(Signature of Notary Pu lic- State of Florida ) (Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificati ASHLEE!1B Type of Identification Produced
r .: ,�
Commission No. 'tom- NotarytsASMeotFlodde Commission No. (Seal)
e CgmmtsslonNofF802t80
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Revised 07/15/2
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
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