HomeMy WebLinkAboutBuilding Permit Application • T I!ST BE COMPLETED FOR APPLICATION T• BE ACCEPTED
• Permit Number,
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Building Permit Applicati t
Services
DEC .I I. 2019
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• I l 1 I '/ 1 IDivision
1/ • . c IST. Lucie •
• - + • unty, Permitting
+ • Commercial •
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co or more,a RECORDED Notice of Commencement Is required.
!11 1:ggy 111
DESIGNER/ENGINEE +r Not Applicable MORTGAGE COMPANY: ^_Not Applicable
Name: Name:
Address: Address:
City; State: City: State;
Zip: Phone _ Zip: _ Phone:
FEE SIMPLE TITLE-HOLDER: T 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 thepermitholder to build the subject structure
which is in conflict with an applicable Home Owners Association rules,bylaws or an covenants that may restrict or prohibit such
structure.Please consult w th your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the gra ting 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 Godes and St.Lucie County Amendments.
The following building per it applications are exempt from undergoing a full concurrency review:room additions,
aCCesSory structures,swim ning 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 i TO YOUR PROPERTY- A NOTICE OF COMMENCEMENT MUST BE RECORIDIED AND
POSTED ON THE J4 IS SITE BEFORE THE FIRST INSPlECT1ON. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of owner/Less aa/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLMD/�
COUNTY OF COUNTY OFli(.1�F.
The fo oing instrument as acknowledged before me The for oing ins mens was acknowledged before me
this, day of zoo by this May of, eJ 20 L`9 by
Name of person making ctatement. �a Name of person making statement. •
:� Personally Known C/ OR Produced Identificat i
Personally Known •OR Produced ]dent l ,
Type of Identification CL'V 9: Type of Identification 121
Produced rh
n Produced
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(�i'gnature of Notary Pu lic-State of Florida) M o g (Signature of Notary Public-State of Florida) i�po q a A
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Commission No ! �. (Seal N W.� Commission No� // (Seal)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
EV.21//19