HomeMy WebLinkAboutBuilding Permit Application .ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Application
Planning,and Development Services
Building and ..•Regulation Division
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Phone: ` . Commercial Residential
PERMIT APPLICATION FOR: To Splect from dropbox, click arrow at the end of line
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Address:Site Plan Name:
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Property Tax ID#: Lot No.
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pie Tltje Holder on nm page if. t # i
constructionfrom the Owner listed above) State or County License:LA(16 f5-79.�26
if value of £i or more,a • ED Notice of cornmencenjent is required.
dESiGNER/ENGINEER: Not Applicable MENEM=MORTGAGE COMPANY: _Not Applicable
Name: Name;
Address: Address:
City: State: City: State:
Zip: Rhone• 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 commented prior to the Issuance of a permit.
St.Lucie County makes no represent tion that is granting a permit sill 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,1 do hereby agree that I Will,'
all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie Caunty 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 twine 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.
_Signature esseeJAgent Signatul`is.ctj &tractor]Li nse Holder
STATE OF FLo m STATE OF FLORIDA -
COUNTY of Z)l ,LCAI� COUNTY 01F
The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me
this day of 1{-J- ,w , , 20 I-Q.by this,L,5„day of J LL I U , 20 by
(Name of personack�ging) (Name of person �ogino'j
(Signature of Notary te'of Florlda 7311nature of Notary Pub tate of Florida)
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Personally Known OR Produced identification Personally Known �r OR Produced Identification
Type of identification Produced Type of Identification Produced
Commission No, ,uu►. Sea Commission
+ tiE LORENZR}!F
"� '� NoIM Public-8lma of Flo da ri``"►"'�•a GENA Lor{€RY• OF
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N, Cammlisich 95796
Revised 67/15/2.0 "�:p„►�;,OF My Comm.F�tpims Feb t.2020 ' Cammisaton sP FF 957887
# ►► My Comm.€xplres Fab 7,2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGkOVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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COMPLETE
INITIALS