HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO I1 UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I l• [ l o'W L %
DESIGNER/ENGIN
Name:
Address:
City:
Zip:
_Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
State
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOI�DER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or ir{stallation 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 arr��rr applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult vi%ith 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 ap roved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building per it applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swi ming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNE ; Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to youlf 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 record' 9 Vur Notice of Commencement.
Signature of Owner/ Agen / Lessee Signature of Contractor/License older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The f¢� oing in u n edge fore me The rgoing in r e dge efore me
this -J � day of by this day o y
(Name of rso cknow dging) (Name of person acknowledging
np N AXZX242�0
(Signature Notary ubl c- State f lorida) (Signature of Notary Public- State f FI ida )
Personally Known OR Prod ed Identification Personally Known OR Produced Identification
Type of Identification ro uced Type of Identification Produ��ced
Commission No ` (Seal) Commission
CRYSTAL MARIE CR
d:►` CRYSTAL MARIE CRUZA O
?p'=
'c MY COMMISSION # FF993217 EXPIRES June 25. 2i
EXPIRES June 25, 2020 a
Revised O%II5/2O14 e. (407)3 153 FlorideNoteryService.co,
REVIEWS
FRON
COUNT R
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS
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