HomeMy WebLinkAboutBuilding Permit Application (2) ALL APPLICABLE INFO MUST BE CO MPLETED FOR APPLICATI,ON TO BE ACCEPTED
Date: Permit Number: y �
Building ■ Application
BuildingPlanning and Ddvelopn7ent Services
• • Code RegulationDivision
//Virginia Avenue,Fort Pierce FL 34992
• • 46 • • • Residential
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Property Tax I D#: Lot No.
Site •lan Name: Block No.
Project Name:
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If of construction $2500 or rRECORDED
08/04/2015 14:53 FAX IM002/003
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DESIGNER/ENGINEER: — Not Applicable IMO ATGAGE COMPANY:
Name: Not Applicable
Not
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 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 ill authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rifles, 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 undergging 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. otice of Commencement must be recorded and post on the jobsite
before the first inspection. in nd to obtain financing, consult with lender ora o'ney before
commen,cing work orre5oKing yodr Notice of Commencement;
gnat of dv) Lessee Signature y ontractor/License Holder
STATE OF
COUNTYOF ORIDAS � CO4TATUNTYOF E OF FLORIDA,,
The forg ing instrumen was acknowledPP�l hefore me the forgoing instrument was acknowledged before me
this day of -f v�. o201Sby this-4 day of 14171 �o/J-Tjy
(Name of person acknowledging) (Name of person acknowledging)
(Sign of Notary Pu ' - tate 'lor'1da ) (Sign atu Notary Public-S a Flo a)
Personally Known d Identi2cation ,4 Personally Known 0 OF,?r &fP0fggIA
Type of Identificatio P.o. � dLIE�,._ Type of Identification Produced
Commission No. ;s . MYCOM��jON#FF165172 EXPIRESSC1ct ber 1,2018
.7 Commission No. L ea
-+ XPIRE October 1,2018 •t::s3 Florida otary ervice.c0m
(471398-01 Floridallola Service.com
Revised 07/1512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS