HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE t MUST BE COMPLETEDFOR t TO BE ACCEPTED
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city: State:
� .•
Code:Zip r
Phone No. /✓ %. &,f"
. •.
Fill in fee simple Tide Holder on •
from owner listed above) • r _ it
11/11/2015 07:40 7724612036 STEVE SMITH AC PAGE 03/03
DESIGNERANGINEER; Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:_
Address: _ Address:
City: State; City: State:
Zip:_ _--Phone: _— Zip: Phone.-
FEE
hone:FEE SIMPLE TITLE FOLDER; X Not Applicable BONDING COMPANY: •X 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 permit will authorize the permit holder to build the subject structure
which is in conflict 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 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 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 re=ding vour Notice of Commencement.
s
_Signaturd of wner/Lessee/Agent Signature of Co tractor/License Holder'
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OE COUNTY OF
The fo aIng instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of IVA(— 20 Eby this , day of 20 by
(Name of person acknowledging) (Name of person acknowledging)
/ W
(Signature of Notary Public-State of Florida) (Signature of Notary Public-5tate of Florida)
Personally Known OR Produced Identification Personally Known _OR Produced Identification
Type of identification Produced Type of Identification Produced
Commission No. �N ission NO.l + �' (Seal)
NOTAIIY Htdal ke Ne}aon Sentamada
STATE OF A NOTARY PUBUG
STATE OF FLOMPA
Revised 07/15/2014 El�w&1?1W19 Cann#FF231202
6/17/2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS