HomeMy WebLinkAboutBuilding Permit Application DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY; Not Applicable
Name: Name:
Address: Address:
City: State: City: - State:
—
Zip: Phone, Zip: Phone-.
FEE SIMPLE TITLE HOLDER: i Not Applicable BONDING COMPANY: —Not Applicable
Name: Name:
Address: Address.-
City: City:
Zip, Phone: Zip- Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or Installation has commenced prior to the Issuance of a permit.
St.Lucie Coun make's no representation that is granting permit will authorize the permit holder to build the subject structure
which is in conWict with an �`ca
,�applicable Home Owners A0o ation rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult w th 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
16 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 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 recorftg your Notice of Commencement.
Signature of Owner/Agent/i@ssee Signature of Contractor License Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTYOF_ J7/le Cry COUNTY OF� r/_ _LOn e
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_Z_day of Oe 7' 20 15- by this r7dayof 126!;r 2015- by
(Name of person acknowledging) (Name of person acknowledging)
Signature 0-Notary PL61-ic-staw' of Florida j (Signtrture of Notary Public-State otKohda-)
Personally Known OR Produced Identification Personally Known V. OR
. OR Produced Identification
Type of Identification Produced Type of Identification Produced.
EC oe
170?020p
Commission No. y
EXPIRES:AprH4,2017 s, MAprllil,2017
REVIEWS FRONT ZONING SUPERVISOR- PkANS VEGETATION SEA TURTLE MANGROVE
COIJNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
BATE
! C
"T-ev. 7/41J14
- 417
&.1101or 4rx-4