HomeMy WebLinkAboutBuilding Permit Application (2) ALL A7 , ICABLE INFO MUST RF COMPLETED FOR APPLICATION TO BE ACCEPTED
Date, ' ♦ ermit •
Building
• Permit
Application
Plontyr and Development
Suildirr r r Code Regulation Division
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Phon 772)4• • . • Residential
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DESIG R ENGINEER: Not Applicable I�ORTGJNGE COMPANY: _ Not Applicable
Name: N me:
Addres A dress:
City: it State: Ci State:
Zip: Phone: Zi Phone.:
FEE Sl ',.PLE TITLE HOLDFR: Not Applicable BONDING COMPANY: _Not Applicable
Name: Nme:
Addres' : A dress:
city: City:
Zip: I' Phone' Zip _Phone
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I certify t �t no work pr installation has commented prior to the issua ce of a permit.
St.Lucie 1111 unryry makes no representation that is granting a permit will avthoriie the permit holder to build the subject structure
which is i �nfllct with any applicable Home Owners Assocaation rules bylaws or and Covenants that may re5krict or prohibit such
structural R{ease consult wrth your Hpme Uwners Assadation and review your deed for any restrictions which may apply.
In consid� tion of the granting of this requested permit,I do hereby aree that I will,in all respects,perform the work
in accord Ce with the approved plans,the Florida Building Codes and t.Lucie County Amendments.
The follo� i g building permit applications are exempt from undergoinj a full concurrency review:room additions;
accessory ructures,swimming pools,fences,walls,signs,screen roo f s and accessory uses to another non-residential use
WARM fa TO OWNER;Your failure to Record a Notice of Co mencement may result in your paying twice for
improv Nients to youeproperty.A Notice of Commencem�it must be recorded and posted on the jobsite
before l4 first inspection. If you intend to obtain financin consult with lender or an attorney before
cornme in work or record r Notice of Commence ent.
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Signatur Owner/Agen/lessee Signature of Contractor/License older
STATE FLORIDA j� ST E OF FLORIDA '�/� ("�
COU I- = t CO NTY OF t i� t !
Th g g instru nt wa a nowledge before me Th rgoing instr ant a cknowledged b fore me
t of 20 y � 20�iy
nn
(Name o rIrsan ac noWledgl ) Game person acknawled ing)
(Sign46fy Pu - tate of Florida) (Signature of Notary Pu iic-st e f Florida)
nown Oft Produced identification Pers I Wally Known OR Produced identification
PersonallyQ
Type of Ida tification Produced Typelof Identification Produced
Commissi Nod ^�� (Seal) Com#nissian Nc'�'`''—i_^ 58a1)
ALtY Codil�ilS3lCEN
EF 197463 CRYSTAL MARS CRIt
Revise 7/15/2fl 34 '!� EXLlES.tune 25,2018 i :ss MY C4i4itil1�3.5ioPt EE39T
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