HomeMy WebLinkAboutBuilding Permit Application ALL • • . • . • r
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Building Permit
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planning r r Development
Building and Cade Regulation
11 Virginia Avenue,Fort
Phone:(772)462-1553 Fax:(772)462-1578 Commercial !!Resi86ntial::,
PERMIT APPLICATION ' Select
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Total Sq.Ft of Construction: Sq.Ft.of First Floo'r:
Cost of Construction: ■
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•• or more,a RECORDED ,
FEB-23-2018 FRI 08:47 AM CENTRAL SCHEDULING FAX No. 3212686138 1,10031
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
i Address: Address: w
City:' State: City: ! State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name: __1
Address: Address:
City: City:
Zip: Phone: Zip: Phone: _
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit do do the work and installation as indicated.
I certify that no work or installation has commenced prior to the Issuance of a permit. I'
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 pians,the Florida Building Codes and 5t.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 nbn-residentlal use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
j improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
i 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.
signature ofr/Lessee/Contractor as Agent for Owner Signature f ontractor/License Holder
STATE OF42RIDA 1 } ' p STATE O FLORIDA ( 1
COUNTY OF V - A IG 1 COUNTY OF t�
The r oing Ihst ntwas acknowled before me Thef r Ding inst pt Was acknowledged before me
this day of 20 ,by this day of zo]$ by
Name of per making statement Name of pets making statement
Personally Known IN OR Produced Identlflcatlon Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
I
(Signature of Notary Public 5 torid� � e n (Signature of Notary Public=,5 t „ onam
+yg Ear . F1723
P'' Catherine Konger
Commission N �� .��M �#FF17237x Commission NoI � I,;G�a1iJ�ion�26,$0 8
ties:
1STFLd�iTY}A2ioT RY,LIC �F,GFfv'.' SONDBATHRU
�u,a�' x97'PLORi1)ANOTAAT.LC'
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA-TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.$/2/17
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