HomeMy WebLinkAboutBuilding Permit Application page 2MORTGAGE COMPANY: N -'Not Appficable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: _
Address:
BONDING COMPANY: 1/f4otApplicable
Name: _
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 Coun�ttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
swhich is tructure. Please consult any
your cHome Owners eAssocciaion and reviewtion yyour deed or for any restrictionnts that s Yv hich may aay restrict orply, prohibit such
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 recording our Notice of Commencement.
LD ;
Lessee/Agent
rxfos€ra�or/Ocense Holder
STATE OF FL I STATE OF FLORi
`` II �
COUNTY OF � MI,
COUNTY OF
The forgoing in w acknowiedgem, ,before me
this day of ) I 20 by
M� Lscy
(Nam.,gf person, acknnwiedone )
(Signature of Notary Public- State of Florida )
Personally Knowny/ OR Produced Identification
Type of Identifiiiati ap -- - •����+�
Commission Nol
Revised 07/15/2014
MY COMMISSt FF904048
EXPIRES July 31, 2019
REVIEWS
FRONT
ZONING
SUPERVISOR
COUNTER
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
The forgoing in ent wa acknowledged b, efore me
this day of�, I 20 Lys by
4(Nam rson acknowledging)
0 (��"D
(Signature of Notary Publ)e- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produc
Commission No. ? MMISSION # FF904
"MM.'r EXPIRES July 31, 2019
,i4Ci)398-0'63 F �Sei,leeion
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW