HomeMy WebLinkAboutHUMPHRIES PERMIT APP / PACKAGE All APPLICABLE INFO MUST BE COMPLETEDFOR APPLICATION TO BE ACCEPTED
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Additional work to be} performed r is it Windows/ Doors
..Mechanical Gas Tank Gas Piping -Emmmww_� S h u t t e r s dENEEPEM---
E I e c t r'i c Plumbing SprinklersGenerator
Total Sq . Ft of Construction :
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PERMIT PPLICATION FOR
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State Countyhcense
is required .
l ice CommencemeM. r St I P R
encement If If value of HAVC 'Ips $7,500 or more, a RECORDED Notice of ecL
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DESIGN ER/ ENGINEER : trot Applicable MORTGAGE COMPANY : _ Not Applicable
Name .: Name *
Ad dr e ss : Address :
Ci t y st ,a t e : City : State : 11
Zip : --- _ Phone Zip : Phone :
FEE SIMPLE TITLE HOLDER : _ Not A p p lic a b l e BONDING COMPANY: _Not Applicable
N ame : Name :
Add re ss : Ad d ress : RIM
Ci ty : CitY .
Zip : P h on e : Zip : P hone:
OWNER/ CONTRACTOR AFFIDVITs. Application is hereby made to obtain a permit to do the work and installation as indicated .
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
whichis 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 � ereby agree that I will, in all respects , perform the work
in accordance with the approved plans, the Florida Bufldins ,'.Ilocies 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 paying twice for
improvements to your property . A Notice of Commencement mintt, recorded e in the public records of St .
Lucie County and posted on the j' obsite before tie first inspection . If you intend to obtain financing, consult
with lender or an attorne before commencin work or recordi* n our Notice of Commencement.
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Signatu! � er/ Lessee/ ontra ' tor as Agent for Owner
STATE OF F-L RIDA
COUNTY of
Swc) l i to ( or affirmed ) and subscribed before me of � Physical Presence or , Online Notarization
this day of � 20�, by
Name of person making sta ment.
i
Personally Known OR Produced Identification
Type of Identification Produced
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( Signature of NoUry Public- State of Florida )
f� bic- State of Florida �
Q{,3uZ-� � "IqV ( Seal ) � MargatetCommission No . E Montepare
My Commission GG 214990
E ral 06/0W022
REVIEWS FRO NT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER R EVI EW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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