HomeMy WebLinkAboutBuilding Permit Application 1— M - I.. M
ALL APPLICABLE • MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building ' Application
� 20116
Planning a • Development
Building and Code Regulation Division St. Lucie County, FL
11 Virginia Avenue,Fort Pierce FL 34982
■ • •2-1578 Commercial Residential
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Address:
Legal Description:
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Site Plan.Name: i 1Block No.
Setbacks Front Back: Right Side: Left Side:
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Cost of Construction: ■
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Address
Zip code. ;—qw'l city. StAtW
_ Phone No.Fillinfeimple
- Title Holder on next page(if different IE-Mail; n CL C'160('7'cy'o C_
from the • . . • . or
if value of construction is 00 or more,a RECORDED Notice of C—ommencement Is required.
sMI0 •;(FNGI`NEE Ncn:P�,pplicable 'MORTG1�GE Ct�MPANY::F Naf.Appli'caf;le<'.
Non Name:
?Address: ' Address:
y: State: City: State;
Zip:. Rhone: Zip: Pharre:
` FEE SIMPLE TiTLE HOLDER: r;�„Not Applicable 81�NDING 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 theermit holder to build the subject structure
which is in conflict with any applicable Horne 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 guilding.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 jvbsite
before the first inspgction. If you intend to obtain financing,consult with lender or an attorney before
commen'cin work or recordiog your Notice of Commencement.
s
_Signatu ner/Le egent Signat ont actor/LicnSe Holder
STAT ORiDA ST OF FLORIDA
COUNTY OF r �— k C47UNTY OF fit' Luc Imo'
Theforgping instrument was acknowledged before me The forgoing instrument was acknowledged before me
this {'`'day of ' ^ 20 Eby this `'day of�f—�-�'� 20 �_by
Yp�SYU► ff
KSiv�a rtii-,
(Name of person�nowledging) (Name of person cknowledging)
t
(Signature of Notary Public State of Florida) (Signature of Notary public-State of Florida)
Personally Known OR Produced Identification Personally Known / OR Produced identification
Type of identification Produced Type of Identification Produced
_ r �
Cor0mission No. '170 Commission NO; Fp0 a D, E(4O
„ ” ea. ISTINA L LOUIE Cl:KRISTINA L LOUDERB CK "s MY COkthrii5S10 22,c
o()A 22 ' EXPIRES A4 uat 7.2 :7
EXPiAES.August 7.4298-0 {Revised OZ/I512014 �?.' ase-oleo FtoddallorarNsarv;e�.c
{40 398-0153 RpddeAlotatys�tvieacorn
REVIEWS FRONT ZONING SUPERV)SOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS