HomeMy WebLinkAboutBuilding Permit app , page 2DESIGNER/ENGIN _ Not Applicable
Name:_
Address:
City:
Zip:
Phone
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
licable
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicabl BO G COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: one: Zip: Phone:
O R/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as inclita .
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
. 4; 1%n AV ATTnneli5tv RFFnDF RFrnRniNr.. YnUR NOTICE.A-COMMENCEMENT."-1)
1�11n IUUK LC
Signatu e of Owner/ Lessee/Contractor as Agent for Owner
Signa of Contractor/License Holder
STATE OF FLORI /
STATE OF FLORID 1
COUNTY OF�i�i%
COUNTY OF r7//�I
The r,,�,o,��ii��g instrurr� nt was act owledged before me
20o by
The fro g instru ent was a knowledged before me
this ay of t 20�Q by
this�!l=ctay of �C
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification ✓J
Personally Known OR Produced llq�gtification QOS
Type of Identification. 0I-ue JESSEDO—�
Produced �Gf� n�:� Commission#GG26306
Type of Identificatio ��.•"'•�'� Commission#GG
Produced/-7/—Id �''�
Expires September
ExpiresSepternber27,20
a7iF Q on ded Thu&idget Notary Senk
A
2 M''FOF.c Bonded lhruBudget No
s
//��\J
(Sig Notary Public- State of Florida)
(Sign of Notary Public- State of Florida )
/''rram�//
Commission No. � (Seal)
Commission No. • � l5� (Seal)
l
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19