HomeMy WebLinkAboutBuilding Permit Application -OR APPLICAM14 TO BE ACaPTED
Date:
Permit Number: i
RECEIVED
Building Permit Application
Planning and Development
AUG
Building r Code J?e9alotlonDivision
II Wrginto Avenue,Fort
Phone,(772)462-1553 Fox-,(772)462-1578 Commercial Residential
PERMIT
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DESIGNERANGINi;ER: x Not Applicable MORTGAGE COMPANY; :,•X Not Applicable
Name: Name:
Address; Address:
City: State: City: —state:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: X 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 an 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 t 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 with lender or an attorney before
commencing work or recording our Notice of Commencement.
nature of owner/Lessee Contractor as Agent for Owner tune of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ,l. l ,U COUNTY OF ti- _. L.0 N w
The fo%oing Instrument was acknowledged before me The forgoing instrument was acknowledged before me
this u day of f k ja ,•_, 20 •(�.,,by thls„4,day of �d,� t�S} .2t7 !2t by
_ V A-, \SS \ r II�r1i11S1�111&, I V M J i l Y'.l I
(Name of person acknowledging) (Name of person acknowledging)
gnature of Notary Public-State of Florld ) Signature of Notary Public-State of Florid
Personally Known _OR Produced Identification Personally Known OR Produced Identification
Type of IdentlflcationType of Identifica on Produced
.4.
SUSAN
Commission No. l' s MYcol iqN#GCiOOM Commission No. •>a+Z!r"
EXPIRES:A02+221 -�", _ SUSAN�1N>:GR4
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Revised 07/15/2014 Putt
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS