HomeMy WebLinkAboutBUILDING PERMIT APPLICATION PAGE 21/4/22, 12:12 PM
ALLEE PERMIT 001.jpg
£IESIGNERJENGIN€ER: Not Applicable
Name. zit
Address: a. i f �. ] f.•+^ to,
i City: _L:' f thne te._
Zip• _ a:L 2 j_ Phone_
i FEE SIMPLE TITLE MOLDER: ___ Not Applicable
Name.
i Address:
Zi Zip: Phone:
MORMGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip Phone: }
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BONDING COMPANY: Not Applicable
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Address:
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Zip Phone.
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OWNW CONTRACTOR AFFIDV IT: 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 tatiorl that is a permit will authorize the permit holder to build the su structure
which conflicts with any ipp� b Homeowners x�aa'a ort rules, bylaws or and covenants that
structure. Please consult wrth your Homeowners Association and review your deed for any restrictions such
may apPIY•
In consideration of the arantiryl of this requested perm, I do hereby agree that I will, in of respects, perform the work
in accordar+ce with the approved plants, the Florida &Adkt Codes and St. LUM County AmerKirnerits.
The following building Permit applications are exempt frown undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, waft, signs, We" rooms and accessary uses to another• non-residential use
WAiOt1NG TO OWNER- You► fasuire to Reewd a tlotke of cwnntrenraettn*m may resuMt in payir>Ig, iwke for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the }obsite before the first inspection. If you intend to obtain financing, consult
Signature of CorMact or - or - Owner builder as applicable
f
STATE OF 11r��
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subscribed bilit"me of �'Physice Presence or Or&rw Notarization
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j Nameof—person making state rnerit
Personally Known OR Produced Identification
3 kient#ir�Producced -�
Comm �sr►t � Notary Public State of Florida
9 Elizabeth Giancontieri
My Commisston HH 047454
Expires 09/2812024
d. 7
REVIEWS 3 FRONT I ZONING j SUPERVISOR ': PLANS VEGETATION g SEA TU tTLE MANGROVE
COUNTER I REVIEW ! REVIEW i REVIEW I REVIEW REVIEW REVIEW
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