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HomeMy WebLinkAboutBuilding Permit Application � | z Lot No. .x DESIGNER/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 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 Count 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 St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concur ncy review: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 r corded a posted on the jobsite before t e f r t inspe do . If you intend to obtain financing, cons It wit lender r a attorney before comme i ork dr rec rdin our Notice of Commencement. S Signatureo Owner/Lessee/Cont ctor s Agent for Owner Signatilrb of Contractor/License er STATE O I FLORID�A''� STAT OF FLORIDA COUNTY F �'IP u��-y— COU OF GRANGE The forgoing instru nt was acknowledged before me The f oing instrument was acknowledged before me 20 b this da of /� 20 b thisg�.dayof g / y y 8 Y PETER A CAFARO III PETER A CAFARO III (Name of person ackno edging) (Name of person acknowledging) 1 MA ( ignatur of Notary Public-St to o Florida) (Si atur ota Pub Ic-State of lorida) Personally Known x OR Produced Identification _ _ Personally Known x ucA Rg r ed Identification Type of Identification P ifr�re Type of Identification Prod �� FF 981647 Ka1��p��'�steoiFr�r da Commission No. FFssisa7 Commission No. a �y �flFE601647 ' E� Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS