HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO
MUST BE COMPLETED •• APPLICATION TO BE ACCEPTED
Date:
Building j'pplication
Planning • • / •/
Building and Code Regulation Divh5ion
11 VhVinlo Avenue,Fo982
Phone:
. 462-1578 Commercial Residential
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■ ■ Shutters E]Windows/Doors
Electric Plumbing OSprinklers Generator Roof
Total Sq.Ft of Construction: S Ft of Fi t Floor!
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Cost of • ■Septic Building
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY; Not Applicable
Name: Name:
Address: Address:
City: � State: City: State:
Zip: _Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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 thepermit 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.
Thefollowing 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, f you intend to obtain financing,consult with lender or an attorney before
commencing work or reo(ding your Notice of Commencement:
zi
Si a Owner/Lessee/Agent25/2rm
f Contractor/License Holder
S F FLORIDA C 1 FLORiDp,
OUNTYOF It COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Y,3 day of_ayqa:!2� 201 Lby thi�day of.}o of,2C _1 a by
(Name of pens n acknowledging) (Name of person acknowledging)
(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
l, fission No.F O09a�� �'"�w''
Commission No �� '�� _,y+,(S �'° elfiF}IST(NA LLOUI7F,R .CK
"ON
¢, i(1i15TiNAI-k4UDER (:K €+: ;.: MYCOMMIS5u7NOFF 22
MY COMMISSION#[=F 9222 7
EXPIRES,August 7,2017 4p 3 133 FlodduNats 3ervEu,-eo
Revised 07/15/2014 A07188a-0183 FlorideNotary$oryfCc,com
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS