HomeMy WebLinkAboutBuilding Permit Application ALLAPPLICABI. INFO MUST BE COMPLETED
ir Permit Number:
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Buil
• * Permiti i i
Planning and Development Services FB I—
Building and Code Regulation Division
IR Virginia Avenue,Fort49
Phone: A I CommercialResidential
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Description:
Property-Fax 10
Lot •
BlockSite Plan Name:
No.5-\-
Project Name:
Setbacks • Right Side, Side:
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ty: State:
• Code:
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I OWN
Fill in fee simple Title Holder on next page if different .........
from the
• • i 1t1
• • . ,
If value of construction is 00 or more,a RECORDED
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IM: NMI,
DESIGNER EJNGIl iAot ApplicableMORTGAGE COMPANY. _Not Applicable
i
Name: i Name
Zip: i Phone:Address: Address:
City: ' State: City: State:
„ Zip: Phone-
FEE SIMPLE TITLE HOLDER: Not applicable BONDING COMPANY: _ of Applicable
Name: I 'i _ Name:
Address: i I Address:
City: I I City: i
Zip: I Phone: I Zip: - Phone:i
I
I certify that now�rk or installation has comr+ced prior to the issuance of a permit.
St.Lucie County m6kes no representation that!is granting a permit will authorize the permit holder to build the Nub]ect structure
which is in conflict with any'applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please cgnsult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requesik permit,I do hereby agree that I will,in all respects;;perform the work
in accordance with,ithe approved plans,the Florida Building Codes and St.Lucie County Amendments. I
The following buildling permit applications are.kempt from undergoing a full concurrency review:ropm additions,
Ecce structuris,swimming pools,fences,;%.Wls,signs,screen rooms and accessory uses to arioijher non-residential use
WARNING TO OWNER:Your failure to Retard a Notice of Commencement may result In your paying twice for
improvements to your property.A Notice of Commencement must be recorded`and posted qn the jobsite
before the first inspectioh. If you intend to obtain financing,consult with lender;or'an attorney before
comm c n work or recordingour Nkice of Commencemen .
_Signature of Owner/Lessee/Agent nature of Contractor/License Efiolder
STATE OF FLO A I STATE OF FLORIDA, y i
! � I COUNTY OF t
COUNTY OF I�+'`.a � •� ' �'.�' '
The f r lnstru nt was acknowledged before me The for Ing instr t was'acknowledged before me
this of I 20 I fabs this ay of 20 by
R
z�i Dill)
(Name of per on kknowledgin (Name of pers n acknowJ ding; I,
I Iii � i1
(Signature of Notary Public-State of Florida)I (Signature of Notary Pu l,ic-Sime of Florida.)
!H
Personally Known! OR Produced Ident fication Personally Known I 6,' Produced ide'`tification
Type of Identification Produced Type of Identification Pr tluc�d iE
iCommission No: 'CRYO
Commission o; L A QM11ED0
, MY COMMIES
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_': 1114Y COiNMISSION#FF904M �I. EXPI
EA11OWS July 31,20is
Revised,0 UW ew .
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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