HomeMy WebLinkAboutBuilding permit app, pg 2DESIGN ER/ENGINEER:
Not Applicable
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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: Applicafton 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,
StAucieCount makes no representation that is granting a hermit will authorize the ermit holder to build the subject structure
which is in conflict with any. aplicable Home Owners Asgodation rules, bylaws or angcovenants that may restrict or prohibit such
structure. Please consult mAthe 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 Ame , ndments.
The following building permit applications are exempt from undergoing a full co.ncurrency review: roornadditions,
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 paying twice for
improve'ments to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before co mencine work or recordine your Notice of Commencement.
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of Contras or/License Holder
Signature of OwnLessee ractor as Agent orcanerSignature
STATE OF FLOR112A
STATE OF FLORIA
COUNTY
COUNTY OF
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REVIEW
DATE
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DATE
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