HomeMy WebLinkAboutBuilding Permit Application (2)7
DESIGNER/ENGINEER: Not Applicable MORTGAGE
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:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
.-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 the permit holder to build the subject structure
which is in: conflict with any applicabie'H.omeQwners Association rules, bylaws or and covenants that may or
restrict 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 ofthis 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.work oriko-rdinQ y.r Notice mirriencement.
9 Y_�p
Signature of Owner/ Lessee/Contractor as Agent fo/Owner
Signature of Contrac tor/LicOnse Holder
STATE OF FLORIDA
STATE OFFLORIDA
COUNTY OF
'COUNTY OF''
The forgoing instru nt was acknowledged before me
The forgoing instrument was acknowledged before me
this _�day of- JL(",A 20n by.
this day of .20 by
In, nck
(Name of person acknowledging)
(Name of person acknowledging)
(Signature of Nota--"- Public- State of Flodrig
(Signature of Notary Public- state of Florida
Personally Known�,. ProducedIdentificationPersona
I ly.known OR Produced Identification
Type of Identifica
Type of Identification
Produced G.
Produced
Commission No. ANGP•
6%� HUFF
Commission No. - (seal)
otary Pub I , c_S ate of Florida
commission # FF 234130
REVIEWS
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80 1 tic
i-1
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
;SUPERVISOR
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
iev. 7/2014