HomeMy WebLinkAboutBUILDING PERMIT APPLICATION,All APPLICABLE INFO MUST BE com! ED FOR APPLICATION TO BE
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BYSt.
Lucie
BuildingApplication
Planning and Development
Building • and Code Regulation Division
11 Virginia Avenue, Fort
Commercial
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—Mechanical GasTank Gas Piping — Shutters —Windows/Doors
Plumbing
— Electric SprinklersGenerator••
Total. Ft of Construction: 96,67 Sq. Ft. of First Floor:00
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Zip Code: 3 zi Jr Fax:
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If value of construction is 2500. •. . Notice of Commencement is required.
Ob
Name: ----
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: XNotApplicable
Name:
Address:
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 authorize the ppermit holder to build the subject 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 granting of 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
commencine work or recordine vour Noll of Cnmmpnrpmpnt
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Signature ofOwne _nt essee,
Signature ofC:6 tf,a oi/i'icenseHolder ,
STATE OF FLORIDg
STATE OF FLORIDA
COUNTY OF �-1 . �\!@ 1�
COUNTY OF SI �JU
The fo oing instrument as acknowledged efore me
this i day of 2l by
The fo oing instrument was acknowledged Wore me
T- dayof SY
_
this 20�by
(Name of person acknowledging)
(Name of person acknowledging)
(Signature li - S t of Florida)
(Signatur o Notary Public- Rte of Florida )
MARYV.��Y4Jb�foA}6Sg� 5d a i
Personally Known ucedIP11f1Yigay�AjggEBUbyp
Type ldeFo'
u�
Type of Identification P aduc S Natary Public - State-n.mssionNFFO
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Commission No. r FF058761
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIE
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
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DATE \-
COMPLETEDC'
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