HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATIONTO BE ACCEPTED
Date. Permit Number: , •`
RECEIVED AUG 2 5
iota N��a-�' '••' z
PlanningBuilding Permit Application
• . Development
Building and Code Regulation Division
11 Virginia Avenue,Port '
Phone:(772)462-1553 Fax:(772)462-lS78 Commercial Residential
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if value
of II or more,a RECORDED Notice of Commencement is required.
Pi,. '4' P l -u@:� il1L�. tr�.�i•'a;C�y%1';'"P'.
DESIGNI^Ft/ENGINI~ER; _Not Applicable . MORTGAGE COMPANY: ,r Not Applicable
Name: Name:
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 ppermit will authorize the permit holder to build the subject structure
which Is In conflict with any applicable Home Owners AssocUlon 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 Commenrerjent must be recorded and posted on the jobsite
bef a the first inspection. If you'ntend to obtain financi , consult wit lender or an a Corney before
com encin w rdin r Notice of Commenc . ent.
Signat re of age ssee Sig a ure o Co tra CeMe-Hold
STAT OFF OR1D STA E OF O
COU O COU T OF,�,,
The forgoing ins ment was acl owledged before.me The forgoing Instr ent was acl owledged before me
this'�day of 20 t by this 7�day of 7.0�by
CAA (:ejim
(Name of p r on acknowledg n ) (Name df person ck bwledging)
ignature otary Public-State of Florida} 0gnature of otary Public-State of Florida)
Person 11 ��yXn OR ProdU entifi tion Personally Kn R Produced Identification
p NNE R6��1'�L
Type o dg n Pro �' Type of Identif' atilt tkpq uce
Natary Public ,o"4y "��:•, JERALYNN:FIELL pres Jul,2�,2017Commission fU Y Public- FCommi xl#FF 03 1 _ lorida- y Comm,Expi2.2p17CornmisslDn
d
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COM PLETE
INITIALS