HomeMy WebLinkAboutBuilding Permit Application ALLAPPYOULE INFO-MUST BE COMOLEMD FOR APPLICATION TO OFACCEPTED
Date: Permit Number:
DevelopmentBuilding POrmit Application
Building and Code ReguMion DIvIslon
•• VjrgWa Avenue,Fort P;erre FL 34982
• • ResidentialY
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Site Plan Name: Block No.
Project Name:
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Name-Jerru Name: fm _M16- an
Zip Code., Fax, City; 1
tar aze:_rPhone No.(Q Zip r
E-Mail: Phone No.
Fill in fee simple Title Holder on nod page(if different E-Mail:])a V1 bcf CL U W)
i� from • • . /4 —VAi
if value of construction 1 1 or more,a RECORDEO'Notice
DESIGNEfi%ENGINEER: V Not Applicable MORTGAGE COMPANY: of Applicable
Name: Name:
Address: Address:
City:___-- State: City:._ __----__-__ _--.. State:
Zip: Phone: Zip; Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _yNotApplicable
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.Lucle County makes no-representation that is granting a permit will authorize the permit holder to build the subject structure
which is in.•c�onrlict 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 con`sideratidn 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 5t.Lucie County Amendments.
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The following building permit applications are exerr►pt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,wails,signs,screen rooms and accessory uses to another non-residential use
WARNING lrO OWNER:Your ftilure 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
commencing work or recordin our Notice of Commencement.
i"' rf y�y� ssee/Agent ry:Q:FCox►tfcor Clcerrse Holder
STATE OF FLORiRAI ,, �,� STATE OF FLO
COUNTY 0 1.A d h,1., COUNTY OF
The ng rust ent was acknowledgq_?efore me The mstr ant was a knowledg afore me
this of x0 Kay this�of 20 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pub ic-Stats of Florida) (Signature of Notary Public-State of Florida)
Personally Known ` OR-Produced Identification Personally Known___. ../..._QR Produced IdentificationType of Type of Identification
�1lYi AGWi M
Commi i M I$#IAN N f=4 � Commission No. `'-. MY CO�ON#FF904048
�XP'1F 8 July;ah A1® ,� EXPIRES July 31-2019
F�p�ldaNO[arySafVlaB.adlt
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEiN
DATE
COMPLETE
INITIALS
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