HomeMy WebLinkAboutBuilding Permit Application D. s r. •. � 1
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Planning I d Development
Building and Code Regulation Division
2300 Virginia Avenue, Fort
Phone: Residentialax:
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Additional workto be nertormed under this permit.T apply: x■
HVAC OGas Tank [:]Gas Piping Shutters Zwindows/Doors
Electric ElPlumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft of First Floor:
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• of • • 3.34 Utilities. • Building
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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 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 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 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 record' our Notice of Commencement.
S
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLO D
COUNTY OF 2 COUNTY OF �{
T r oing instr t was acknowledg d efore me The or oing instru was acknowled d before me
today of 20 y th ay of 20�� by
(Name of person acknowledging) (Name of'person acknowledging)
Al
(Signature of Notary Pu7bl'c-State o loricl ) (Signature of Notary
Pu Personally Knowny OR Produced Identification Personally Known Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.�� �SS�z� MELISAARME mmi ion Nam r—_ Sg7 S (Seal)
MY COMMISSION#I E 855825
off€ EXPIRES:Decembe 28,2016
01�,•'r'•�;y'd.,,- MEUSAARMENT
RCV1SeCi 07/15/2014 ; •_ MY COMMISSION 855825
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EXPIRES:December28,2016
•••o° londedThrUNotaryPubUGUnderwrfters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS ►�