HomeMy WebLinkAboutBuilding Permit Application • UST IRE •MPLETED FOR ! 1 BE ACCEPTED
Date: Permit Number:
RECE11-1f) OCT 05 2015
Building Permit Application
Planning ar 0ewelopmentServIces
Building and Code Regulation Division
II Virginia Avenue,Fort Pierce 1134982
Phone: •2-1553 Fax;(772)462-1578 Commercial Residential
F��MIT APPLICATION FOR: ToSelect fromdropbox, click arrowtheend oflline
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Name
•IIr f
'Address: I r .. r r • •
City- State:,�LZ " rr _ss: til r• '•
• rr- r
PhoneNo • Code. ' 1 r
Phone • 772 461-142�
HolderFill in fee sImpJe Title @:.
from the Owner listed . . . or County11
If value of construction is of or more, • . Notice of Commencement
10/05/2015 08:16 7724612036 STEVE SMITH AC PAGE 03/03
DESIGNE ENGINEER: Not Applicable MORTGAGIE COMPANY: ( Not Applicable
Name: Name•
Address: Address:
city: states City: I Stat
Zip: Phone: Zip: phone: i '
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY. --XNot Appiicabie
Name: Name:
Address: Address:_
City: city: I
Zip: Phone: Zip: Phone: I
-7 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 will authorize the permit holder to huId the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that mar restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictlans 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 pians,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room Idditions, '
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessary uses to another exon-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in yoyr paying twice far
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 are a torney before
commencing rk or re dlng your Notice of Commencement. ;
s
T $Ignature of weer/Lessee/Agent Signature of co tractor License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The fo1go,
ng instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of JUn-( 2045 by this day of 1Z0 by
(Name of person acknowledging) (Name of person acknowledging)
AV/
(Signature of Notary Public-State of Florida) (Signature of Notary Public-Skate of Florida)
Personally Known OR Produced Identification Personally Known _OR Produded identification
Type of identification Produced Type of Identification Produced i
Commission No.q1Z1-4VJ3 MOW"
�°a ission No_ HOZ j (Seal)
Fiktaies 1149104 Made
STATE OF f9. IDAMIAX NC7TAR1'Pt
11311C
• 1 STATE OF FLORIDA
Revised 07/15/201 - E>K 5117/?019 � C mee*FFig12o2
al,i7*019
I
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
I •