HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit • i • ��
BuildingPermit • • •
Plunning and Development Services
Building and CodeRegulation Division
2300 Virginia Avenue,Fort
Phone: 4. 462-1578 commercial Residential
PERMIT APPLICATION • -
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DESIGNER/ENGINEER: "NotMApplicable 0
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T.G
A.
G
E COMPANY; Not Applicable
Name: Na
me•
Address: Ades�
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,wells,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commenceme*nt 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 recording your Notice of Commencement.
9-
414-
Signature of Owner/Lessee/Agent Signature of Contractor/License Rolder,
STATE OF FLORIDA STATE OF FLORID
COUNTY OF fjL- 1A.JCOUNTY OF
The for" instrvmqntwasacknowledged before me The for Ing Instrument was acknowledged before me
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this_L9_'t1 day of ()Q_J0QQ X- 20 tLby this 1,1 day of 20 lip—by
(Name of person acknowledging) (Name f person acknowledging)
Signature of Notary Public-State of Fl •d)a) (Signature of Notary Public-St,
Per.5onafly Known OR Produced Identification Personally Known_�R Produced Identification,
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS