HomeMy WebLinkAboutBUILDING PERMIT APPLICATION-P j L I . I
DESIGNER/ENGINEER: _Not Applicable i MORTGAGE COMPANY: _Not Applicable
Name:
Address:
01, t State:
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FEE SIMPLE TITLE HOLDER: _Not Applicable
Name:
AddressIP
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01' t.
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ZIP: Phone:
Name-.
Address.
City: State:
Zip: Phone*
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I cer-tify that no work or installation has commenced prior to the issuance of a permit,
t. Lucie Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con lict 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 i;l in all respects, perform the worm
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications ar exempt from undergoing a full concu rrency review. morn 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 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 attarnev before commencing work or recording your Notice of Commencement.
Sign re of owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF S 4%
Swarp to (or affirmed) and subscribed before me of � Physical Presence or Online Notarisation
this day of ZUA4 _ , 20by
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Name of person making statement.
Personally Known OR Produced ldentifitation
Type of Identification Produced PC %00
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(Signature of Notary c- 4�� NgGIVENS
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tary bt�C •State of rlarida
Commission No. � ��p�g� �1 H1� Oa535�DZ5
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
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COMPLETED
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