HomeMy WebLinkAboutLEFFEW 2 SUtPOPLEMEE TAL 00INSTRUMN LEN LAVY QNG ORP,\AA"i" P:
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IFEE SOMPLE VOILE HOLDER' �Not Applicable SON MPAXV —Not Applicable
Name: Name:
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I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Counter 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 ansll covenants that may restrict or prohibit such
structure.Please consult with your Homeowners 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 1 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 anei-aptfrom undergoing a full concuriencV review.room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessoryy eases to another non-residential use
WARNING TO CWHERa Vo r fallulTe tie L cord pc-suat on Vou[r pQ@VonS�tluh_€a 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,consuk with lender or an attorney before
commencina work or recording our Notice of Comrrlencement.
_ s
nature of Owner/Lessee/Agent SighlCure of Contractor License Holder
STATE E OF aOR9®A 4 I
T TIE OF FL@lRODA
COO um ry OF ,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this—I—day of 40q . 28 this_�_day of�"� ,20 l 7 by
(name erson acknowledging) (Name of pCrson acknowledging)
rl
(Signature of Notary Public-
/State of Florida) (Signature of Notary Public State of Florida�
Personally Known r: ()R Produced Identification Personal) �-
Type of Identification Pro y Known—�Cun educed Identification
e of Identification Prod
Pie,, MIKE MARTIN
p 1 `Aes fflwi4y MIKE IIAARIN
Commission Poo. � Publie State ii1 Flori mmission No. ' : I nmmisslon a FF 216551 VOID Public:-state of FlorMy Comm.Expires Apr 5,2Q 9 C01111111si1on#t FF 216951' oPF Expires Apr 5.20
Revised 07/15/2014 "��'" d pls ti
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS