HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -
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Building Permit Application AUG 17 2018
Planning and Development Services
Building and Code Regulation Division Permitting SCS a; i.ment
2300 Virginia Avenue, Fort Pierce FL 34982 , I Count-Yr FL
Phone:(772)462-1553 Fax: (772)462-1578 Commercial
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
SUPPLEMENTAL CONST.RUGTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 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 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 ncing, consult with lender or an attorney befor
commen 'n work or recordingour Notice ncement. ?' ^'''
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Signature f Owner/Lessee/Contractor as Agent fo Si gWatur of Contractor/License Holder m<
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STATE OF FLORIDA 9�r-� STATE OF FLORIDA C� rng Q
COUNTY OF sn COUNTY OF J L��� r-6 ir
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The forgoing instru Lnt was ac nowledged before MT The forgoing instru ent was a nowledge efore me
this day of20rX by this day of 20 by
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Name of person snaking statement Name of person making statement
Personally Known ✓ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
I J174.4Y/ AV J_
(Signature ofo ary Public-State of FI ida) (Signature of Not Public-State of Florida
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17