HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA139E INFO MJJ5T BE COMPLETED FOR APPLICATION TO HE ACCEPTED
Q_I Permit Number
Building Permit Application
•
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone- t62-1553 Fax:(772)462-1578 Commercial ResiClential
PERMIT APPLICATION FO' - - - - -
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r-11 In fee rnple Title Holder on next pa - SIM. L/.. a I l 63 wry .i .• `
from the Owner listed above) State or CXnty Ucense. .'. /
valueIf of constructiontI or more, RECORDED Notice of • required.
&MMIll! ME
DESIGNER/ENGINEER; Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip, Phone:
FEE SIMPLE TITLEHOLDER: —NotApplicable BONDING COMPANY: —NotApplicable ,
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 theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or an9covenants 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 f you intend to obtain financing,consult with lender Oran attorney before
commencing work or re
o�din g your Notice of Commencement.
Si e f Owner/Lessee/Agent
Sire f Contractor/LicenseHolder
S
S OF
FLORIDA =OF FLORIDA
BOUNTY OF- LL,c',-c COUNTY OF.
The forizoing instrument was acknowledged efore me The forgoing instrument was acknowledged before me
this lAday of AUJ9ZSL
Zo i�tby this �Z� day of A t-L4 cam; .20 1 �by
J 7-- -
_C-itoSSma,f o — Tec4 6'
(Name of persn acknowledging) (Name of persorl acknowledging)
64—
{Signature ofNotary Public-State of Florida) (Signature of Notary Public-State of Florida
Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification
Type of IdentificationProd ced Type of identification Produced
Commission Noecro0q�':;I:; (Seaft Comr lission No.F/':-b0?aA_z1_ eKRI$TINA L LOUDER I I kCK
WSTINA L LOUDERJiR
My COMMISSION#r-f:(1 @222
MY COMMISSION#FF 22 EM121AFA AYRUW7_2 7
EXPIAE!3 August 7,2017
Revised 07/1512014 409-0183 Ilorld!,kotwyfinice.com .1(401n3a"10 R0r1d*Notery$9rv1o*.ca i I
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE