HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATIONTO BE ACCEPTED
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Building Permit Application
Planning and Development Services
Building♦and Code Regulation Division
11 Virginia Avenue,Fort Pierce FL 34982
Phone: / CommercialResidential
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Address:61
Zip Code. ��
IN
Phone No,
J
•Fill in fee Simple Title Holder on next page(If different
from the Owner listed above)
• • •►
if VRIUR
Of 1 1RKORDED Notice of Commencement Is required.
DESIGNER ENGINEER: Not Applicable
MOR
TG
A
GE COMPANY. Not Applicable
Name: Name;
Address: Address:
City: State: — City: _.�State,
Zip: Phone; Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable 130NPING COMPANY: Not Applicable
Name: Name:
Address: Address;
City: City:
Zip: Phone:, Zip: OFoni-
I certify that no work or Installation has commenced prior to the issuance of 6 permit.
Lucie County makes no representation that.1s granting a permit will authorize the permit holder to build the subject str cture
a
owners ACsoc ation rule;,bylaws or an c restrict or prpbible such
which Is in conflict with any applicable Home own covenants that may,rL
structure,Please consult with your Home Owners Assoclati6n and review your deed flor any restrictions which may apply.
in consideration of the granting of this requested permit,i4o 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 roams 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
beforO the first Inspection. if you intend to obtain financing, donsult with lender or an attorney before
commencin&work or recording our Notice of Commencement,
_Z!V� - - , 1111a,&_ s
Signature of Owner/Lessee/Agent Signature of Contr2ctor/Pcense Holder
STATE OF FLOTIDA STATE OF FLORIQA
COUNTY OF r . J COUNTY OF
forgoing Instrument was acknowledged before me The fariloing instrument was acknowledged before me
this lb"day of DLAQQ= 20 Up_by thisWilidayof OL±QbW 20 „U by
0 A
e of person acknowledging) (N%ne of person acknowledging)
—wature of Notary Public-Statp(6& rlda Signature of Notary Public-Stat Florida)
Public-Sta7tg�FF_lo
Person 9%Ifth ion Personally Know_n0R PgLxendld ,
gnt'is Ion
Type 0 n Produ2#9A i Dagoz*RUF� Type 0
GEN Z IJU
A CQF!&NZ RUF
Notary Public-Siiw of f1prida"
State of�"�
Comml I MISAwn*ff 90W Comm! Notary Public-State of
4,FF 96 967
My Comm:Expires Feb 7,x0'ga 0MMISSIon#FF 96 M967
res fet) 2024
My CoMT,Expires 1`07,2026
Revised 07/1512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER,;. REVIEW 'REVIEW REVIEW REVIEW REVIEW REVIEW
COMPLETE
INITIALS