HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO C 1
Date: 7,6� L Permit Number:
RECEIVED i 4
Building 1 App • I
Planning and Development Services
Building • • Code Regulation Division
// Virginia Avenue,Fort
Phone:
• 462-1578 Commqrcial Residential
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Lot No.
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07/20/2015 12:02 FAX 0 002/003
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DESIGNER(ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: .�_ iName:
Address: Address:
City: State: ;City: State: .
Zip: Phone: 'Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable 'BONDING COMPANY: Not Applicable
Name: 'Name:
Address: Address:
City: 'City:
Zip: Phone: :Zip: Phone:
i
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 subject structure
which is in conflict with any applicable Home Owners Association ryles,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 youaying twice for
improvements to your property. A Notice of Commenceinent must be recorded and p on the jobsite
before the first inspection. If y intend to obtain financing,consult with lender ora rney before
comm cing vArk or recorur Notice of Commencement.
.l r.
4Si ��ofwner/Agen es Ee Sign r o tr t Lica e H61der
STATE OF FLORIDA G STATE OF FLORIDA
COUNTY OF r- COUNTY OF 5 GvU•e_
The forgoing instrument was acknowlerippil before me The forgoing instrument was acknowledeed before me
this�.0 day of J o�01 S`by this•22 day of ✓L �_. a0 �"6y
(Name of person acknowledging} (Name of person acknowledging}
(Sign of Notary Pu ' - tate lorida)
(Sign Notary Public-S a Flo a}
Personally Known de
Personally Known 0 )R..? cg QAYA
Type of Identificatio P.r1Yili (1 Type of Identification Produced.
• MY COM���jON#FF165172 EXPIRES pct ber 1,2018
Commission No. ,N . Commission No. >ea�
art XP1RE October 1,2018 :•u�s7 Florida otary ervice.com
407 39t1•g15� Floridallota Service.com
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS