HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALLAPPLICABLEIN 0 MUST BE COMPLETED FUI
K AFFULAI ION TO BE ACCEPTED
Date:
Permit Number:
SGA
NEED
RECEIVED
APR 2 5 2018
Bui di
it Application
Planning and Development Services
ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential
-_N L T NrE
TEA, ACONIST 1,14, OT' MA�
DESIGNER/ENGINEER: Not Applicable
MORTGAGE.COMPANY: Not Applicable
Name:
Name:Micheal Raman
Address:
Address:,
City: State:
City: Fort Pierce State:
Zip: Phone'
Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Address:4252 Bandy B1,d.
Address:
City:
City:
Zip: 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 authorlie the permit h6lder-to build the subjd'ct".structure
which is in conflict with any applicable Home Owners Association rule�, bylawg or and covenants that may restrict or prohibit such
structure. Please consult with your'Home Owners Association and review yourcleed forany restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respec . t� 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 rnay'iiR�sult 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 your Notice of Commencement.
gle
Signature of Owi(er/Less S/Contractor. as Agent for Owner
neractoeLicense Holder
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Name of person making statement
Name of pers king statement
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Personally KnownK OR Produced Identification
Personally Known OR Produced Identification
Type of, I d f
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Type of [dent* * ra±i
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(Si nature of Not I 1qZp-te of Florida
(S(g�nare. of Notary Public- State of Florida
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DATE'
COMPLETED
Rev. 8/2/17