HomeMy WebLinkAbout1604-0033 CUf-I Nl`Y
ALL APPLICABLE INFO LIST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building
• . - Application
Planning and Development Services
Building and Code Regulation Division
11 Virginia Avenue,FortPierce
462-1553
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Project Name;
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Total Sq.Ft of Construction:
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Floor;
Cost . r ■ ■Septic Building Height:
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Zip Code;
Phone ND'—f
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
If value of construttion Is
•i or more,a RECORDED Notice of commencement is required.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address;
City: State* City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicabl+e? BONDING COMPANY: `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
imp ovements to your property.A Notice of Commence ent must be recorded and posted on the jobsite
bef a the first inspection. If you'ntend to obtain fin: 1 ,consult wlt lender or an a torney before
com encin w din r Notice of Cpmmenc . ent.
Signat re of _ ssee sig ture 0C tra ce se Holddl
STATOFF STA COU E O OF�� - � �
COU 0
The forgoing instr ent w acknowledged before me The forgoing instru nt was�c�nowledged before me
this, day of =X
20„may this day of
L'L_,20--Vy
( .PA-,l A Z.'Ewj_�, cn'\anhkt-/'1
ome of pers n ac no edging (Name of p r on acknowledg'n )
ISE
Ignature of otary Public-State a iorida) ( store of Na ry Public-State a Florida)
Personally KnownProduced identification Personally Known �OR produced j PN WA
Type of identificatio Prod 'type of Identification Produced oum _
ftr
'} Ji RALYN r ''mres Jul 22.2077
Commission No. 0 orp 0941 �taUSSEtL Commission No_�r�=ate" „ (9ea}I#FF 038392
State of Florida
to;.' Y Comm,Ex i
'.,off A tos d4i 22,2077
. 2
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS