HomeMy WebLinkAboutBuilding Permit Application �
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from the Owner listed above) State or County License;
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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:
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 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 prope.rty..A:Notice,of Commencement must be recorded and posted on the jobsite
before the first inspection If you intend to obtaimfinancing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
_Signature of Owner/Lessee/Agent ture of ontractor/License Holder
STATE OF FLORIDA . STATE OF FLO ID
COUNTY OF 'kCt-Y`IiY\ COUNTY OF ��" I
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 15-by this ` '1 day of DCGgwftv)>e C 20 (Ot by
i
Jud 'P� eY-C4e
(Name of person acknowledging) (Name of person acknowledging)
- a i LQ Q i:L_ -
(Signature of Notary blit-State of Florida) �(Signat a of Nota Publli tate of Florida)
Personally Known OR Produced identification V Personally Known t/ OR Produced Identification
Type of Identification Produced'Wc CjL S'4634141S Type of Identification Produced
Commission No.(n(-i 97-SVb o ission No. (Seal)
,�p�tY PUBIi ANGELAYOUNG
1iY pu':, CASSANDRA M VOLA E a° My COMMISSION#FF 951069
Commission X GG 923210 N , c�` EXPIRES:April 12.2020
Revised 0 /15/2014 a ` . My Comm.Expires Oct 1b,2023 "T�oFF�°� 9anaodltrubudget NowryServces
Bonded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS