HomeMy WebLinkAboutBUILDING PERMIT APPLICATION
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DESIGNER/ENGINEER: _ Not Applicable M6R GAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
city: tate: City: State•
Zip; ftne Zip: Ph
FEE SIMPLE TITLE DE _ Not Applicable BONDING COMPA . Not Applicable
.Name: Name-.
Adress: Address:
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ty:Gity:
p Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application 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_
St. Lucie County makes no'representation that is granting a permit will authorize the permit holder to build the subject structure
which conflicts with an applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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•CQmmencement 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 po ed on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an iWarney before commencin work or recording our Notice of Commencement.
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Signature of Owner/ Lessee Contractor a Agent for
STATE OF FLORIDA
COUNTY OF
Sworn to (or affix ed) and subscribed before me of sical Presence or Online Notarization
this m day of � ZO� (( by
Name of person making statement.
Personally Known i/ OR Produced Identification
Type of I entificatlon Produced
(Sig ture of otary Public- State of Florida)
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Commission No (seal) �IHyGpMrytISSION#GG289447
E7(PtR�: >=E6 24, 2023
Bogged through 1st State Instrraqca
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