HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1
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Name:
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Code: C City: lL 7` State: _
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in fee simple Title Holder on next page ( if different E-Mail:
m the Owner listed above) State or ntY license:
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�Ialue of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLD R: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COM ANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPAN : _Not Applicable
Name:
Address: IV I'm
City!
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
rich is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
ucture. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
e following building permit applications are exempt from undergoing a full concurrency review: room additions,
cessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
'ARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
iprovements to your property. A Notice of Commencement must be recorded and posted on the jobsite
?fore the first inspection. If you intend to obtain financing, consult with lender or an attorney before
tmmencing work or recording vour Notice of Commencement.
Signature of Owner/ Lessee/Agent
'ATE OF FLORIDA
)LINTY OF
The �f,00ing instru=twasknowledge before me
this"day of20 Cby
1
Name of person acknowledging)
ature of N t�Publif- State of Florida )
finally Known OR Produced Identification
of Identification Produced .
mission No.
Revised 07/15/2014
FR CES DONIZA
M5(t'®I� ISSION 0 FF 014070
EXPIRES: July 27, 2017
Bonded Thru Notary Public underwrite
k s
t nature of Contractor/License Holder
STATE OF FLORIDA f�
COUNTY OF A!7
The forgoing instru ent wa acknowledged before me
this �1 day of 20 0 by
(Name of person acknowledging)
(Signature of \0.ar
Public- ate of FloridaPersonally KnowOR Produced Identification
Type of Identification P. --- ---
' MY COM¢��IO� N FF 014Q
Commission No.*i - EXPIFl�S 9UI� 27, 201'
'�f� BondedThruNotaryPublicUnderw.
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