HomeMy WebLinkAboutBuilding Permit Application �
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DESIGNER/ENGINEER: ,Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: `Not Applicable 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 guying twice for
improvements to your p7operty.A Notice of Commencement must be recorded and posted on the jobsite
before the st insrrc 1f you intend to obtain financing,cons ith I( r an attorney before
co. ncin work our Notice of Commencem
i'
S
Si ure of Owner/Le en ;��TEO
Contractor LJ nse` Ider
STATE OF FLOi FLTai-A
A COUNTYOF 1 t�Q t r� COUNTY OFA 0
Theo rgping instrument was acknowledged before me The forgoing instrument was acknowledged before me
this may of 20 I-Lby this 12day of .)L&L'Q , 20 by
J54.ok4
(Name,of person acknowledging) (Name of person acknowledging)
• • l I
(Signature of&btary Public-State of Florida} (Signature(bf Notary Public-State of Florida)
Personally Known OR Pro uced Identification Personally Known OR Produced Identification �5
Type of Identification Produced �r, f)L D Type of Identification Produced Flan DL-
-.Gc MARYLEE MATTIS oMARYLEE MATrJS
'���� (��9` Oh1NISSfOPt#EE 881495 Commission No.f E �l�U r, ' ( M8l01J*EE 991445
Commission No� "X �Ar
t IBES:March 9,2017
yq , P!RcS;Mamh 6,2017 FFtcP`O B]nd:dTtN
)For.F%. Rmd.-dTt 8udpiN=rysC'mu& MO Nobryserac:s
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS