HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO M ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
•. Permit Number,
Building Permit Application
Planning a . Development
Building
00 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residentialr
PERMIT APPLICATIONFOR: Select - end of like
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Address- 8001 Eden Rd
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rFort Pierce State.
Zip Code: 34951 Fa�: 772 461-2036
Phone• •
2/2015 15:20 7724612036 STEVE SMITH AC PAGE 03/03
1
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY• Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip:_ Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _C 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 apermit 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,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.If you intend to obtain financing,consult with lender or an attorney before
commencing w rk or EeMding your Notice of Commencement.
.1.52KZ�_
s
_Signature of weer/Lessee/Agent Signature of co tractor License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The fo oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this, day of 'JUnk 20 Eby thisday of � R1lK zo . .by
116�" JA�h 5tia
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Pubilc-State of Florida)
Personally Known OR Produced Identification . Personally Known„A OR Produced identification
Type of Identification Produced Type of Identification Produced
Commission No. Oki IAW if
No� fission No.f fl" 120i (Sem*
Noma swimaft
E OR Ill. DA tw Vrf PUBLIC
. f STATE OF FLORIDA
Revised 07/15/2014 rs IIi11l11019 Qam�FFZ31
6117!2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE 2
COMPLETE
INITIALS