HomeMy WebLinkAboutBuilding permit app pg 2DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable ..
Name: ________________ _ Name: _______________ _
Address=---------------Clty: ____ __, ______ State:
Zip: _____ Phone. _________ _
Address: __________ -=----
aty: ____ =-______ S.tate:
Zip: ____ Phone: ________ _
FEE SIMPl.f TITLE HOlDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: ________________ _ Name: ______________ _
Address: _____________ _ Address: _______________ _
City: _______________ _
Zip: ____ Phone: ________ _ City: -----------------Zip: Phone: ----------------
OWNER/ CONTRACTOR AfflDVlT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 certify that no work or installation has commem:ed prior to the issuance of a pennlt.
St Lucie County makes no ~latlon that is l!nlf'ltlng a pl!flJlit wiH authorize the permit holder to burld the su~ structure
which conflicts with any apJJ!itable Homeowners Jlssociatioi1 rules. bylaws or and cqvenants that may restrict or prohibit such
structure. Please consult with you, Homeowners Association and rt!VK!W you, deed for any restrictions which may apply.
In consideration of the granting of this requested pennit, I do hereby agree that I will. in aH respects. perform the work
in accordance with the approwd plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a fuU concurrency nNiew: room additions,
accessory structures. swimming pools. fences, walls, signs, screen rooms and accessory uses to anotfler non-residential use
WARNING TO OWNER: Your fall.._to Recmd a Natic:e of~may-'t 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 attomev before commencine: work or recordine: vour Notice of Commencement.
Signature of Owner/ lessee/Contractor as Agent for Owner
STATE OF FLORIDA <::L_ I,,,.;,.
COUNlYOF ____ JT_;_~-------✓ Physical Presence or __ Online Notarization Sworn to (or affirmed) and subscribed before me of
this 'll5ll-dav of :fo,fll(O Oj • 20_1f by
Matb!fi.ofma~~~nt
Personally Known ✓ OR Produced ldentlfication __
Type ~~~cation P?l uced
/;£/4'~.-~ \,/,~
(Signature of Notarv lie· . 'lffl CH,ISTINE JO.'(>E (;QNWEll
CommissiOI ; , ~·•.. Noury D1Jbl\c ~bf Florid1
\~t :lj Commission# GG 914701
'~ci,,,.,,~/ My Comm. E.xptrHAutZ1, 202 ◄
.. ,. · "1ondt<I throuth National Notary Ann,
REVIEWS
DATE
RECEIVED
DATE
COMPI.ETED
FRONT ZONING
COUNTER REVIEW
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW