HomeMy WebLinkAboutBuilding Permit ApplicationFEE 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 o an attorney before
commencing work o. ording your Notice of Commencement.
s
_ Sign�o ner/ Lessee/Agent Signature r License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF VO t Vh rvL t rJ)pNCOUNTY OF ►4 r"
The forgoing instrument was acknowledged before me
this 0) day of 1AQ3 t )Sr , 20 Eby
(Name of perso ackno iIedgfr�r INALVIS MARTINEZ
MY COMMISSION #FF151518
"•• ;o
'�oFF,d?:° EXPIRES August 14, 2018
'eridel�elar�'tom,.;........,,.,
(Signature of otary PL.Ill- _)idle of rJ, '
The forgoing instrument was acknowledged before me
this 03 day of AUG LST_ 20 J� by
,: .7
t'
(Name of perso knowl 'z.' INALVIS MARTINEZ
ac���orh�d'Y, `�=:
_jyp( MY COMMISSION #FF151518
+'Ford" EXPIRES August 14, 2018
(407) 398-0153 FloridallotarySeryice nom
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification Y_ Personally Known OR Produced Identification
Type of Identification Produced &-L_L1 _C�no -- J\i - 3loL-:1 Type of Identification Produced 052''4 -000- ?y' 3r"r- •/ .
Commission No. fF 1515 1'S (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
SUPERVISOR PLANS
REVIEW REVIEW
VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
Property Tax ID #:.3H I -:sqo - o m H - c"
Lot No. 7
Site Plan Name:
Block No. `17
Project Name:
Setbacks Front
Back: Right Side:
Left Side:
�C C1rlY�v� (,fLOl3r Ivv�� ave Comm( Iv 2 TUry I -t 3 Iz 1C �v
CONSTRUCTION INFORMATION:
% i .. '..''h'.. ..
Additional work to be ertormed under this permit —check ajl apply: L
HVAC � Gas Tank ❑ Shutters Windows/DoorsGas Piping _ ❑
Electric ❑ Plumbing ❑ Sprinklers Generator Roof
Total Sq. Ft of Construction: SQ. Ft. of First Floor:
Cost of Construction: $ 1 )r(*"(—) , O0 Utilities: 0 Sewer []Septic Building Height:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.