HomeMy WebLinkAboutBuilding Permit Application .LFINFOMUSI E COMPLETED FOR APPLICATIONTO 1
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Development
de Regulation DivIslon
Avenue,Fort Pierce
FL 34982
462-1553 Fax:(772)462-1578 Commercial• Residential
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DESIGNER E GINEER: Not Applicable MORTGAGE COMPANY- ,Not Appiic�ble
Name: Name:
Address: Address:
City: State: _* City: State.
Zip: Phone: Zip: Phone:
FEE SIMPLE I ITLE HOLDER: Not App€icabie BONDING COMPANY: —Not Applicable
Name: Name:
Address: Address:
City: City:
Z€p` Phone: Zip: Phone.•
I certify that n work or Installation has commenced prior to the Issuance of a permit,
St.Lucie Coun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is to con ct with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Pleas, consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideratior of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance m Ith the approved plans,the Florida building Codes and St.Lucie County Amendments.
The following b Ilding permit applications are exempt from undergoing a full concurrency review:room;additions,
accessory strud ires,swimming pogls,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING T OWNER:Your failure to Record a Notice of Commencement may result In your paying twice for
imp ovemen to your property.A Notice of Commence ent must be recorded and posted on the jobsite
bet a the fi t inspection, If you 'ntend to obtain financi ,consult wit lender or an attorney before
corn encin din Ar.Notice of Comment . ent.
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Slant re of a ee 5ig ure o Co ra ce se Hotd
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STAT OF F 5TA OF RPAI
COU O - COU OF �. 1
The forgoing i tr ment wa acknowledged efore me The forgoing Instr ent was cknowledged before me
this Za-day 20 t Y this day of�t _..—,ZD_ obY
LILL t - ,Vr" LM4 ;
(Name of rso acknowl Ing) (Mame rson acknowled i g}
Slgrtature N tary Public-State of Florida) gnature of tary Public-State of Florida)
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Personally Kn h ,,, »roc uce en _ Personally Known :i.Q�,Producetl idents ;cat a` n
Type of Identifi t n ` # r JERALYNNE RUSSi L•;L
J£RALYNNE RIME-1-1, Type of Identiflcatio
N4tary Public-State of Florida
e . # ,.ary u c tate o norlda
commission Nc °rM. s Jul 22,2017 Commission No. C,rnrpS lies Jul 22,2017
Commission FF 038392 f�,.� Gommtrssion#FF 038392
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Revised 071 5/2014
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPI.E T E
INITIALS
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