HomeMy WebLinkAboutSMITH DEMO APPALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Q/—o2ly—dL�i,� Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential '
JPEMIT APPLICATION FOR: Pool inground
i PROPOSED IMPROVEMENT LOCATION:
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: _
Address:
City:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
State
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 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 1 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 fp""fit inaction. If you intend to obtain financing, consult with lender or an attorney before
comme,I1PKdW9,fk or recording your Notice of Commencement.
ntractor as Agent for Owner Signature of " ntract r/Li ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF- COUNTY COUNTY OF _ /�%fj T//J
The forgoing instru t was acknowledged before me The forgoing instrument was acknowledged before me
this ,746 day of 20 .4' / by this _1!?�day of 20 V by
/'
(Name of persona wledging )
(Signatur f Notary Public- State of Florida)
Personally Known OR Produced Id ntification
Type of Identification Produced_FC
mission No. C-6o?90/7e yam( eal)
Revised 07/ 15I2014
Ryan Figman
(Name of person acknowledging }
(Signature Notary Public- State of Florida )gOf
Personally Known ✓/ OR Produced identification
Type of 4dentification Produced
Commission No. 6! a0./ O (Seal)
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INITIALS
q011 Notary Public State of Ronde "" o YI
Notary Public State of Florida
?N, Lori A Moxley aON,W Lori A Moxiey
My Commission GG 280148 i4y Commission GG 280148
oxa� Expires 1112812022 1 '+����� ExpirL>s 11/28i2022