HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n Q
Date: Permit Number:
A 10-Cl
Building Permit Application JUN 9
Planning and Development Services 2017
Building and Code Regulation Division PERPii177ING
2300 Virginia Avenue, Fort Pierce FL-34982 St. Lucie County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential -
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line. I
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required
DESIGNER/ENGINEER:
Name:
Address:
City: State:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
State.
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: f Not Applicable
Name: �� Name: /1/ �l
Address: r Address:
City: City:
Zip: Phone: Zip: Phone:
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 s�rbject structure
which is 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 grantineof 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 Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
9
_ Signature of Ownedr/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF
The
fing inst nt was acknowledged efore me
thisday of 20/.7by
(Name of person ackno edging )
4�mw
(Signature of Notary Public- to of Florida )
Personally Known jar i
Type of Identificationq ro Mpgd •
prances Donza < '
Commission No. c� MyComii(,Fsee1)GG092440
oF�0 Expires07/27/2021
Revised 07/15/2014
STATE OF FLORI4a4l—
COUNTY OF
The for oing instr nt was acknowledged before me
this day of 20 1Z by
Personally Known RuBi'�l�ib@a'i+d�ti&n%6
Type of Identification P tii� Notary Public State of Florida
? Frances onza
Commission No. a My CorpEnls jgn GG 092440
Expires 021
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