HomeMy WebLinkAboutBuilding Permit Application (2) 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 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 thepermit 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
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.
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Signature of Contra t r/License Holder I
_Signature of Owner see/ nt g i
STATE OF FLORIDA STATE OF FLORIDA-i_
COUNTY OF COUNTY OF o.Jl 'UktA*A-0
The forgoing instr. ent was acknowledge before me The for ing instrum t was acknowledged before me I
this day of 20 Mby this day of 20��by iM
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Name of p on acknowledging) (Name of erson acknowledging)
CLft, bif A�S�
2 Q ignature of Notary P is ASt of Florida) (Signature 4f Notary Pu -State of Florida )
ce
rsonally Known OR Produced Identification Personally Known OR Produced Identification
pe of Identification Produced Type of Identification Produced
'~ mmission No. Ff)VII01P9 (Seal) Commission No.� (Seal)
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MAY R.MCP'-!.. '�:5 .a - i
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Revised 07/15/2014 0. &; !;2� j�Y, 3��amo tpl ust 620188
..., �tMMINltllfii Mruro.800.185.7018
REVIEWS FRONT ZONING I SUPERVISOR, PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE ---- --- -- _ — - -- 1
COMPLETE
INITIALS