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PropertyTar ` r �1�� Lot No.
Site Plan Name: 131OCk No.
Project Name:
Setbacks Front Back: Right Side: Left .-
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MAR-28-2017 TUE 09: 51 AM CE1. NTRAL SCHEDULING FAX No. 3212686138 P, 003
NFL
,..
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: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip:_Phone-*__- -.__-_--Phone- zip: Phone:
i certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie countty�makes no representation that is granting a Ppermit will authorize the permit holder to build the subject structure
which is in confllct with anyapplicable Nome Owpers Assoclatlon 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 6emptfrom undergoing a full concurrency review:room additlons,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory rises to another non-residential use
WA,RNiNG TO OWNER:Your failure to Record a Notice of Commencement may result in your paying tw)ce 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 leader or an attorney before
commencing work or recording your Notice of Commencement.
Signa reo�;n_er/Agent/Lessee Signature of o tractor/License Holder
i ST EORIDA 1 STATE OF FLORIDA
'
COUNTY OF _1 �• l./"'�Vi Cr. COUNTY OF� �
The�ing Inst ent wasacknowledgedknowledged before me The forgoing Inst-r w s acknowledgefi4i efore me
this d ay of (te _ 20 rb this- day of Y '20-M by
(Mame of person acknowledging) (Name of person acknowledging)
r ,
(Signature of Notary Public-State of ori a) (Sig a ure f Notar`y(P blit-State orida)
Personally Known_ OR Prad dentification Personally Known / �--_OR Pro ced Identification,_„_,.,
Type of Identif Produced 'Type of Identification Produced_
•--{ ,�• 4 Ca erne or
Catherine Ko r
Commission No� ! � conixwlauiiR@i? R21mmission N Qn I�F1723
?2
:,�►� � �Expim;0028, 01S � 'r'Expires;dL'1`28,20
2 IB
a r gND$ATliAU ~ . �., BONDED Muir
•
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER • REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
[TATE
COMPLETE
LLLINITIALS -