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HomeMy WebLinkAboutBuilding Permit Application (2) x s � DESIGNER/ENGINEER: __Mot Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: of Applicable BONDING COMPANY: A, 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 thepermit 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 St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concur ncyreview:room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and acces o uses to another non-residential use WARNING TO OWNER:Your failure to Record a Notice of Commence ent ay result in your paying twice for improvements to your roperty.A Notice of Commencement mus be recorded a posted on the jobsite before Te4ftrt insp do . If you intend to obtain financing, cons It wit lender r a attorney before commeiork •r rec rdin our Notice of Commencement. S Signature o Owner/Lessee/Cont ctor s Agent for Owner Signat r of Contractor/License er STATE O FLORIDA. STAT OF FLORIDA COUNTY F U'Y u�"'�" COU OF ORANGE The �oLing instrument was acknowledged before me The fo oing instrument was acknowledged before me thisi ay of 17 C-- , 201?by this I� itay of � 4-C. 20 0 by PETER A CAFARO III PETER A CAFARO III (Name of person ackno edging) (Name of person acknowledging) $ignatiu_rl of Notary Public-St to o -Florida) (Sijnatu4otaFubl—ic-State of lorida) Personally Known x OR Produced Identification _ Personally Known xlfr d, ed5_Identification 0, ���` Type of Identification P [f ' _ m Type of Identification Produce� ` itat9 Publ taasFlan�a Commission No. FF 98164,71a- vou _ gftn;12C0=R1Rd7 Commission No. FF 981647 � ` MyC fda1Dni F96��B7 dF$ e4liet �i? 20 P1�s0�J2 ��0 pLY v Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS