HomeMy WebLinkAboutBuilding Permit Application i
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S.lJ ZREV!'UNTAL CC)NSTRUCTION LIEN LAZA! lNFC?RIUTATIQN
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DESIGNER ENGINEER: _Not ApplicableMORTGAGE COMPANY:
Not Applicable
Name: Name:
Address:. Address:
City: 'State: City: State:
Zip` Phone: Zip, Phone I
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FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: Not Applicable,
Name: Name:
Address: Address:
City: City: l
Zip: Phone- Zip: Phone:
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I certifythatno work orinstallation has commenced prior to the issuance.of a permit.
St.Lucie;Countyy snakes no representation that is granting a permit will authorize the permit holderto build the su�ject structure,_
which is in contli.ct with'any applicable Horne Owners-Association rules,.bylaws or.and covenants-that may-restrict,orproh+btt�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;accoedance 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
accessorystructures,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 Commencement must be recorded and posted on,the jobsite
before the4itst inspection. If you intend to obtain financing,consult with lender or an attorneybefore
commencing work or recording our Notice of Commencement.
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_Signature of Owner/Lessee/Agent Signaturie.of,Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF$ainrtuci- COUNTY OFsaintt.ucie,
The forgoing instrument.was acknowledged.before me The forgoing instrument was acknowledged before me
th'ls'z4�'`day ofg lew,byr 20" by this 2sah day,of September 20
William Palladino .l William Palladino
(Name of person`acknowledging) (Name of'person acknowledging.). I
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(Signature of Notary Public State.of Florida) (Signature:of NotaryPublic-State of Florida,)
Personally Known X OR Produced Identification Personally Known x, OR Produced Identification
Type Type.of Identification Produced T yp ofldentifica"tion Produced '
EE2l)8516 1�Ypis Commission No,ec'20866. Seal
Commission No. "(Sea # MPALLADINC,
* . MY COMMISSION#EE 205t6' r° ,••.°`�+ WILUAMPALEAQir�O'.
s'r�OF� `4� aonaaltnrsu Nasrysetv�ts a,�. ti4� EXPIRES:J6ne14,20f6
Revised 07/15/2014 �i o� &*dT>uusr i►rot ys s
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION. SEA TURTLE MANGROVE
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