HomeMy WebLinkAboutBuilding Permit Application ALL AP LE ■ M ST BE COMPLIETFI)FOR APPLICATION TO BE ACCEPTED
a Permit Number:
CC��IYJT 'Y RECEIVED
Planning anj Development Services Building Permit Application A' '
Building . .. Division
2300 Virginid Avenue,Fort Pierce FL 34982
Phone: 4.2-1578 ' COMMe*rcial
Residential
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Total Sq.Ft of Construction: 5 Ft of First Floor'.
Cost Of construction: Utilitles-11-sewer Eleptic Building Height-
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In fee . - Title Holder on nextpagedifferent
•m the dwner listed above) + • � A �.��
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DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: I Address:
City: I State: City: State:
Zip: I Phone: __ Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: I Phone: zip: Phone_
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I certify that no work or installation has commenced prior to the issuance of a permit.
St_Lucie Coun�II make no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict wit 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 conslderatioIn 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 CommenceJert must be recorded and posted on the jobsite
be f a the first inspection. If you 'ntend to obtain financiconsultwit lender or an attorney before
corn encinw din r Notice of Commencent.
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Signat a of See Sig re o Co ra ice se Hold
,r, _ff
STAT OF F ORI \ ,� STA EO ORIDA
COU 0 t COU OF
The forgoing int ent was acknowledged before me The forgoing inst ent wa�agknowledged before me
this�Oday of 20 j this may of 1 20
ame o e on acknowledging) (Name of person cknowledging)
gnature of try Public-State of Florida) rgnature otary Public-State of Florida)
Personally Known OR Produced Identification Personally Known �'DR Produced identification
Type of Identification Produced Type of identification Produced
Commission No. ff55 a Commission No. �t m JEReRCAte RUSSELt
J[3F�AMAE RUSSELL .`'a'� .� Notary Public.State of Florida
Y,_ Notary_a&ic-Star¢of Florida
�,, 1 .axp res u122,2017 ' ,�`�`
a"�`cvp• `' Commission#FF 096392
Revised 07/15/ '/111"�'`�` Commission FF 038392 �„mp
REVIEWS FRONT ZONING SUPERVISOR PLANS 'VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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