HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA13LE INFO MUST BE COMPLETED FOR APPLICATIONTO BE ACCEPTED
Date, 1.1d Permit • •
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�t3C13V 7 2015
Building Application
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If value of
construction3$2SOO or more,a RECORDED Notice of Commencement is required.
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IDESIGNER/ENGIN>; R: Not Applicable MORi GI'�GE
COMPANY: _Not Applicable
Nae. NaM6.
Address: l 'Address:
'City: State: :City: State:
Zip: P one: I i Zip: Phone:
FEE SIMPLE-TITLE N LDER _Not Applicable BONDING COMPANY: _Not Applicable
Name, Name:
Address: I I Address: _
City: I city:
Zip:.__ _. .._ -- None: Zip: Phone:
I certify that no work or�nstalla ion has commenced prior to the issuance of a permit.
St.Lucie County makes o repre entation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict w►th nY appl cable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consul 7th yo r Home Owners Association and review your deed for any restrictions which-may apply.
In consideration of the g anting f this requested permit,i do hereby agree that i will,In all respects,perform the work
in accordance with'the a)provec plans,the Florida Building codes and St.Lucie County Amendments.
The following building pi rm]t ap 3ficationS are exempt from undergoing a full concurrency review:room additions,
accessory structures,sw mming jools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWN R.;Yot r failure to Record a Notice of Commencement may result in your paying twice for
improvements to yo r,pro erty.A Notice 6f Commencement must be recorded and posted on the jobsite
before the first irisp ion. f you intend to obtain financing,consult with lender or an attorney before
commencing work o I recor ling YoOr Notice of Commencement.
6
Signature of Owner/Age /Less a Signature of Contractor/License older
STATE OF FLORIDA y� STATE OF FLORIDA
COUNTY OF ��l t COUNTY OF
� I ,
The f oing ins m nt�l s etE owledged before me The or oing rn urnent was ack owledged before me
this�ay of ..,Z:!
20by
this�ay of 20��jby
1 I 1�r''
Z,01
(Name of person ackno dging (Name of person acknow edging)
(signature of N6taryPu iaStat of F ori a) (Signature of Notary Public tat f Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of identification Produced—'
Commission No.
CRYSTAL �� C� Tp� IE CRUZAOQ
M15SI N fl;EE19Y469 M ioN 0 EE197400
EXPIRES dune 25,2016 EXPIRES June 25,2016
Revised 07/15/2014 , eona,w t�otiaoeo,av oom `-
REVIEWS FRON ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUN R REVIEW .REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
I
EO/EO 39dd ZIId HOV39 N3SN317 6ELSESEZLL EE:EO TIOZ/170/60